Societies release first appropriate use criteria for paediatric heart disease

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The American College of Cardiology, along with eight partnering societies, have released the first appropriate use criteria for suspected heart disease in paediatric patients.

The “2014 Appropriate use criteria for initial transthoracic echocardiography in outpatient pediatric cardiology” was developed in collaboration with the American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography.

“The purpose of the new criteria is to improve patient care and outcomes in a cost-effective manner,” says Robert Campbell, chief of the Children’s Healthcare of Atlanta Sibley Heart Center, Atlanta, USA, professor of Pediatrics at Emory University School of Medicine, and chair of the writing committee. “This document will also help to improve quality within practices.”


The writing group identified 113 indications for outpatient paediatric echocardiography based on common clinical scenarios and/or clinical practice guidelines. An independent rating panel then evaluated each indication as “Appropriate,” “May Be Appropriate,” or “Rarely Appropriate.” Campbell stresses that the paper will help to reduce the rate of “Rarely Appropriate” echocardiograms in this patient population.


“The goal is to familiarise both paediatricians and paediatric cardiologists when echocardiography may help a physician elucidate a quicker diagnosis and when other diagnostic pathways may be more useful,” adds Campbell. “For example, the writing committee spent a lot of time on the importance of recognising when an echocardiogram may or may not be needed for a murmur. Much of the determination lies with the auscultation skills of the physician and the writing committee wanted to encourage paediatricians not to immediately order an echo, especially for innocent sounding murmurs.”


The full paper has been published online on the websites of the American College of Cardiology, American Society of Echocardiography and Society for Cardiovascular Angiography and Interventions.

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