EKGs of Low Risk Patients Remain Common and Associated With More Cardiac Testing

MedicalResearch.com Interview with:
Sacha Bhatia, MD, MBA, FRCPC
Scientist, Women’s College Research Institute
Director, Women’s College Hospital Institute for Health System Solutions and Virtual Care
Cardiologist, Women’s College Hospital and University Health Network
Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The USPSTF recommends against screening with resting electrocardiography (ECG) for the prediction of coronary heart disease (CHD) events in asymptomatic adults at low risk for CHD events. We conducted a retrospective cohort study of the frequency of resting ECGs in low risk patients within 30 days of an annual health exam. We found that 21.5% of low risk patients in Ontario, Canada had a ECG, with significant variation among primary care physicians (1.8% to 76.1%). Moreover, low risk patients who had a ECG were five times more likely to receive another cardiac test or cardiology consultation than those that did not receive an ECG. At one year the rate of mortality, cardiac hospitalizations and revascularization was <0.5% in each group.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: ECGs in low risk patients during an Annual Health Exam is common with significant ordering variation among primary care physicians. Potentially unnecessary ECGs could lead to other testing or cardiology visits, with no significant impact on patient outcomes

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research should study interventions to reduce unnecessary ECG ordering in primary care practices.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Bhatia RS, Bouck Z, Ivers NM, Mecredy G, Singh J, Pendrith C, Ko DT, Martin D, Wijeysundera HC, Tu JV, Wilson L, Wintemute K, Dorian P, Tepper J, Austin PC, Glazier RH, Levinson W. Electrocardiograms in Low-Risk Patients Undergoing An Annual Health Examination. JAMA Intern Med. Published online July 10, 2017. doi:10.1001/jamainternmed.2017.2649

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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