PDF(Pubmed)
Abstract：
UNASSIGNED: Cardiovascular disease is the leading cause of morbidity and mortality globally. Echocardiography is a commonly used method for assessing the condition of patients with cardiovascular disease. However, little is known about the population characteristics of patients who are recommended for echocardiographic examinations.
UNASSIGNED: The National Ambulatory Medical Care Survey was a cross-sectional survey previously undertaken in the USA. In this study, publicly accessible data from the National Ambulatory Medical Care Survey database (for 2007-2016 and 2018-2019; data for 2017 was not published) were utilized to create a nomogram based on significant risk predictors. The study was performed in accordance with the relevant guidelines and regulations stipulated in the National Ambulatory Medical Care Survey database. Patients were randomly assigned to one of two groups: training cohort or validation cohort. The latter was used to assess the reliability of the prediction nomogram. Decision curve analysis was performed to evaluate the net benefit. Propensity score matching analysis was used to evaluate the relevance of echocardiography to clinical decision-making.
UNASSIGNED: A total of 217,178 outpatients were enrolled. Multivariable logistic regression analysis demonstrated that hypertension, hyperlipidemia, coronary artery disease/ischemic heart disease/history of myocardial infarction, congestive heart failure, major reason for visit, metropolitan statistical area, cerebrovascular disease/history of stroke or transient ischemic attack, previously assessed, insurance, referred, diagnosis, and reason for visit were all predictors of echocardiogram prescription in outpatients. The reliability of the predictive nomogram was confirmed in the validation cohort. After propensity score matching, there was a significant difference in new cardiovascular agent prescriptions between the echocardiogram and no echocardiogram groups (P < 0.01).
UNASSIGNED: In this cohort study, a nomogram based on the characteristics of outpatients was developed to predict the possibility of prescribing echocardiography. The echocardiogram group was more likely to be prescribed new cardiovascular agents. These findings may contribute to providing information about the gap between actual utilizations and guidelines and the actual outpatient practice, as well as meeting the needs of outpatients.
UNASSIGNED: The National Ambulatory Medical Care Survey was a cross-sectional survey previously undertaken in the USA. In this study, publicly accessible data from the National Ambulatory Medical Care Survey database (for 2007-2016 and 2018-2019; data for 2017 was not published) were utilized to create a nomogram based on significant risk predictors. The study was performed in accordance with the relevant guidelines and regulations stipulated in the National Ambulatory Medical Care Survey database. Patients were randomly assigned to one of two groups: training cohort or validation cohort. The latter was used to assess the reliability of the prediction nomogram. Decision curve analysis was performed to evaluate the net benefit. Propensity score matching analysis was used to evaluate the relevance of echocardiography to clinical decision-making.
UNASSIGNED: A total of 217,178 outpatients were enrolled. Multivariable logistic regression analysis demonstrated that hypertension, hyperlipidemia, coronary artery disease/ischemic heart disease/history of myocardial infarction, congestive heart failure, major reason for visit, metropolitan statistical area, cerebrovascular disease/history of stroke or transient ischemic attack, previously assessed, insurance, referred, diagnosis, and reason for visit were all predictors of echocardiogram prescription in outpatients. The reliability of the predictive nomogram was confirmed in the validation cohort. After propensity score matching, there was a significant difference in new cardiovascular agent prescriptions between the echocardiogram and no echocardiogram groups (P < 0.01).
UNASSIGNED: In this cohort study, a nomogram based on the characteristics of outpatients was developed to predict the possibility of prescribing echocardiography. The echocardiogram group was more likely to be prescribed new cardiovascular agents. These findings may contribute to providing information about the gap between actual utilizations and guidelines and the actual outpatient practice, as well as meeting the needs of outpatients.
摘要：
■心血管疾病是全球发病率和死亡率的主要原因。超声心动图是评估心血管疾病患者病情的常用方法。然而,对推荐进行超声心动图检查的患者的人群特征知之甚少.
■全国门诊医疗调查是以前在美国进行的横断面调查。在这项研究中,我们利用国家非住院医疗调查数据库中的公开数据(2007-2016年和2018-2019年;2017年的数据未公布),根据重大风险预测因子创建列线图.该研究是根据国家门诊医疗调查数据库中规定的相关指南和规定进行的。患者被随机分配到两组中的一组：训练队列或验证队列。后者用于评估预测列线图的可靠性。进行决策曲线分析以评估净收益。倾向评分匹配分析用于评估超声心动图与临床决策的相关性。
■共纳入217,178例门诊患者。多因素logistic回归分析显示，高血压，高脂血症,冠状动脉疾病/缺血性心脏病/心肌梗死病史，充血性心力衰竭,访问的主要原因，大都市统计区，脑血管疾病/中风或短暂性脑缺血发作史，以前评估过的,保险,引用,诊断,就诊原因均为门诊超声心动图处方的预测因素。在验证队列中证实了预测列线图的可靠性。在倾向得分匹配后，超声心动图组与无超声心动图组之间的新心血管药物处方差异有统计学意义（P<0.01）。
■在这项队列研究中，我们根据门诊患者的特点编制了列线图,以预测超声心动图处方的可能性.超声心动图组更有可能服用新的心血管药物。这些发现可能有助于提供有关实际使用和指南与实际门诊实践之间差距的信息。以及满足门诊病人的需求。
■全国门诊医疗调查是以前在美国进行的横断面调查。在这项研究中,我们利用国家非住院医疗调查数据库中的公开数据(2007-2016年和2018-2019年;2017年的数据未公布),根据重大风险预测因子创建列线图.该研究是根据国家门诊医疗调查数据库中规定的相关指南和规定进行的。患者被随机分配到两组中的一组：训练队列或验证队列。后者用于评估预测列线图的可靠性。进行决策曲线分析以评估净收益。倾向评分匹配分析用于评估超声心动图与临床决策的相关性。
■共纳入217,178例门诊患者。多因素logistic回归分析显示，高血压，高脂血症,冠状动脉疾病/缺血性心脏病/心肌梗死病史，充血性心力衰竭,访问的主要原因，大都市统计区，脑血管疾病/中风或短暂性脑缺血发作史，以前评估过的,保险,引用,诊断,就诊原因均为门诊超声心动图处方的预测因素。在验证队列中证实了预测列线图的可靠性。在倾向得分匹配后，超声心动图组与无超声心动图组之间的新心血管药物处方差异有统计学意义（P<0.01）。
■在这项队列研究中，我们根据门诊患者的特点编制了列线图,以预测超声心动图处方的可能性.超声心动图组更有可能服用新的心血管药物。这些发现可能有助于提供有关实际使用和指南与实际门诊实践之间差距的信息。以及满足门诊病人的需求。
