Is ExECG your default diagnostic?

Posted on by Kurt Jensen

"Exercise stress electrocardiography (ExECG) is underutilized as the initial test modality in patients with interpretable electrocardiograms who are able to exercise. Although stress myocardial imaging techniques provide valuable diagnostic and prognostic information, variables derived from ExECG can yield substantial data for risk stratification, either supplementary to imaging variables or without concurrent imaging. (abstract)

What's your diagnostic test workflow?

A recent paper in JACC: Cardiovascular Imaging reviewed literature on the latest advances in exercise stress electrocardiography (ExECG) and argued that despite the ACC's recommendations, the test is still "underutilized" as the initial diagnostic test modality for suspected coronary artery disease.

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Are you “Choosing Wisely” with Cardiac Imaging?

Posted on by Kurt Jensen

Results are in from the Choosing Wisely initiative - a campaign designed to reduce the use of frequent tests deemed "low value" - like cardiac imaging.

A recently published study from JAMA Internal Medicine examining the frequency and trends of services from 2012 Choosing Wisely recommendations across 25 million Anthem health plan members found statistically significant reductions in cardiac imaging and other "low value" services.

Some context: many uses of cardiac imaging were deemed "low value" by the ACC in 2012.

The American College of Cardiology contributed to some of the earliest Choosing Wisely recommendations from 2012 - the recommendations that this study tracked. One of these recommendations has since been withdrawn due to new science, but the four that remain relate to cardiac imaging.

They are:

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