Reduce unnecessary cardiac screening in low-risk patients

Reduce unnecessary cardiac screening in low-risk patients
Reduce unnecessary cardiac screening in low-risk patients

HealthDay News -- For low-risk patients, cardiac screening with resting or stress electrocardiography, stress echocardiography, or myocardial perfusion imaging is not recommended, results of a study published in the Annals of Internal Medicine suggest.

“Despite its intuitive appeal, the benefit of cardiac screening in low-risk adults has long been questioned,” wrote Roger Chou, MD, of the Oregon Health & Science University in Portland, and colleagues.

To evaluate the effectiveness of cardiac screening among low-risk patients, the investigators culled results of a systematic review, current Preventive Services Task Force (USPSTF) recommendations on screening with echocardiography (ECG), and standards developed by the American College of Cardiology and other professional societies.

“This article is not based on a formal systematic review, but instead seeks to provide practical advice based on the best available evidence,” noted the researchers.

Cardiac screening has not been associated with improved patient outcomes. Furthermore, it has been associated with potential harms due to false-positive results that lead to unnecessary testing and procedures, reported the scientists.

For adult patients at low risk for coronary heart disease, cardiac screening is likely to be particularly inefficient given the low prevalence and predictive values of testing in this population, and the low likelihood that positive findings will impact management. Within a low-risk population, clinicians should focus on strategies for treating modifiable risk factors and encouraging healthy levels of exercise.

“To be most effective, efforts to reduce the use of imaging should be multifocal and should address clinician behaviors, patient expectations, direct-to-consumer screening programs, and financial incentives,” concluded the study authors.

References

  1. Chou R et al. Ann Intern Med. 2015; doi: 10.7326/M14-1225
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