Impact of the 2016 ASE/EACVI Guidelines on diastolic function reporting in routine clinical practice

Area of Science:

• Cardiology
• Echocardiography
• Clinical Practice Guidelines

Background:

• Diastolic Function (DF) assessment is crucial for diagnosing heart conditions.
• The 2016 ASE/EACVI guidelines aimed to standardize DF reporting.
• Understanding the impact of these guidelines on clinical practice is essential.

Purpose of the Study:

• To evaluate the effect of the 2016 ASE/EACVI guidelines on Diastolic Function (DF) reporting in routine clinical practice.
• To analyze changes in the reporting of normal DF, diastolic dysfunction (DD), indeterminate DF, and nonreported DF post-guidelines.

Main Methods:

• Retrospective analysis of 20,843 transthoracic echocardiograms.
• Data collected from 9 months before and 18 months after the 2016 guideline release.
• Quarterly trend analysis and provider-level analysis of DF reporting patterns.

Main Results:

• Reporting of DD decreased by 57% (P < .001) after the 2016 guidelines.
• Normal DF reporting increased by 76% (P < .001), and nonreported DF increased by 266% (P < .001).
• Significant decreases in reporting for Grade 1 and Grade 2 DD were observed, while Grade 3 DD remained stable.

Conclusions:

• The 2016 guidelines significantly altered DF reporting, decreasing DD diagnoses, especially lower grades.
• Increased non-reporting of DF suggests a potential decrease in provider confidence.
• Inter-provider heterogeneity in reporting improved for higher-grade DD but worsened for Grade 1 DD.