Outpatient echocardiography in the evaluation of innocent murmurs in children: utilisation benchmarking

Area of Science:

• Pediatric Cardiology
• Diagnostic Imaging
• Healthcare Utilization

Background:

• Echocardiography is a key diagnostic tool in pediatric cardiology.
• Appropriate use criteria for echocardiography exist but lack benchmarking data.
• Understanding current utilization patterns is crucial for guideline adherence.

Purpose of the Study:

• To benchmark echocardiography utilization for innocent murmurs in pediatric outpatient settings.
• To compare utilization rates between two major pediatric cardiology centers.
• To identify variations in echocardiography use based on patient age and physician experience.

Main Methods:

• Retrospective cohort study of 23,114 outpatients aged 0-18 years with an "innocent murmur" diagnosis.
• Data collected from two large pediatric cardiology centers between July 2007 and October 2010.
• Analysis of echocardiography utilization based on center, patient age, and physician years of service.

Main Results:

• Overall echocardiography utilization was 43.1%, with no significant difference between centers (45.2% vs. 40.4%).
• Utilization varied significantly by provider within each center.
• Patients aged 1-5 years showed the lowest utilization rate (32.7%).

Conclusions:

• Echocardiography utilization for innocent murmurs is comparable across major pediatric cardiology centers.
• Significant provider-level variability in utilization exists, underscoring the need for consistent application of guidelines.
• These findings provide initial benchmarks and emphasize the importance of appropriate use criteria in pediatric cardiology.