Service should be reserved for equivocal cases

BMJ 1995;311:327 (29 July)

Letters

Service should be reserved for equivocal cases

EDITOR,--C M Francis and colleagues claim that their open accessechocardiography service was "well used" and led to advice beinggiven to change management for nearly 70% of patients.¹ I fearthat they have been unsuccessful if they were trying to increasethe currently low rates of prescription of angiotensin convertingenzyme inhibitors in heart failure: the number of patients referredfor echocardiography was small compared with the numbers ofpatients with known and unknown left ventricular dysfunctionin the study population. The study population can be assumedto be roughly 1.1 million (assuming average practice lists forthe 550 general practitioners canvassed). Among these patientsup to 2% may already have left ventricular dysfunction² (thatis, over 22000) and an annual incidence of left ventriculardysfunction of 0.1 to -0.2% (that is, 1100-2200 patients) coudbe expected. So the referral of 259 patients for echocardiographyover five months is . . . [Full text of this article]

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Relevant Article

Open access echocardiography in management of heart failure in the community: C M Francis, L Caruana, P Kearney, M Love, G R Sutherland, I R Starkey, T R D Shaw, and J J V McMurray
BMJ 1995 310: 634-636. [Abstract] [Full Text]