The role of appropriateness criteria in the clinical practice of echocardiography

Abstract

Over the past decade, there have been sustained increases in utilization and costs of echocardiographic procedures. As a result, concerns have been raised about potential overuse or misuse of echocardiography. Appropriateness criteria (AC) represent a physician-directed effort to define appropriate utilization of cardiac imaging procedures. Recent studies of the AC for echocardiography suggest they can be feasibly applied and can successfully stratify appropriate clinical practice of echocardiography. Implementation of the AC in clinical practice appears to represent the best way to minimize unnecessary studies while ensuring patient access to appropriate echocardiography procedures. It also represents a viable alternative to precertification procedures in which non-clinicians determine access to echocardiography. This article reviews some of the relevant issues concerning the role of the AC in the responsible use of echocardiographic imaging.