Societies Issue First Appropriate Use Criteria for Pediatric Heart Disease

September 29, 2014—The American College of Cardiology (ACC) with eight partnering societies released the first appropriate use criteria for suspected heart disease in pediatric 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 full paper is available on the websites of the ACC, American Society of Echocardiography, and Society for Cardiovascular Angiography and Interventions.

In the ACC announcement, the chair of the document’s writing group, Robert Campbell, MD, commented, “The purpose of the new criteria is to improve patient care and outcomes in a cost-effective manner. This document will also help to improve quality within practices.”  Dr. Campbell is chief of the Children’s Healthcare of Atlanta Sibley Heart Center and professor of pediatrics at Emory University School of Medicine in Atlanta, Georgia.

According to the ACC press release, the writing group identified 113 indications for outpatient pediatric 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.” The paper will help to reduce the rate of “Rarely Appropriate” echocardiograms in this patient population, advised Dr. Campbell. 

He added, “The goal is to familiarize both pediatricians and pediatric cardiologists when echocardiography may help a physician elucidate a quicker diagnosis and when other diagnostic pathways may be more useful. For example, the writing committee spent a lot of time on the importance of recognizing 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 pediatricians not to immediately order an echo, especially for innocent-sounding murmurs.”