Evidence map›Paper›PMID 30174265›Full record

ArticleJournal of cardiothoracic and vascular anesthesia2019

Practice Pattern Variation in the Use of Transesophageal Echocardiography for Open Valve Cardiac Surgery.

Emily J MacKay, Peter W Groeneveld, Lee A Fleisher, Nimesh D Desai, Jacob T Gutsche, John G Augoustides, Prakash A Patel, Mark D Neuman

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiothoracic and vascular anesthesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Observational
  3. Complications Associated With Transesophageal Echocardiography in Transcatheter Structural Cardiac Interventions.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2023
    Article
  4. Article
  5. Survey of centers performing cardiovascular magnetic resonance in pediatric and congenital heart disease: a report of the Society for Cardiovascular Magnetic Resonance.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022
    Article
  6. Article
  7. Transesophageal Echocardiography, Mortality, and Length of Hospitalization after Cardiac Valve Surgery.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2020
    Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Emily J MacKayDepartment of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Penn Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania, Philadelphia, PA; Penn's Cardiovascular Outcomes, Quality and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA. Electronic address: emily.mackay@uphs.upenn.edu.
Peter W GroeneveldDepartment of Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Penn's Cardiovascular Outcomes, Quality and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
Lee A FleisherDepartment of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Penn Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania, Philadelphia, PA.
Nimesh D DesaiDivision of Cardiovascular Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Penn's Cardiovascular Outcomes, Quality and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
Jacob T GutscheDepartment of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
John G AugoustidesDepartment of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Prakash A PatelDepartment of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Penn's Cardiovascular Outcomes, Quality and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA.
Mark D NeumanDepartment of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Penn's Cardiovascular Outcomes, Quality and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.

Funding

Training in Critical Care Health Policy ResearchT32HL098054 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI Scott D Halpern · 2010 to 2026
$8.2M
NHLBI NIH HHS T32 HL098054
6 · The paper itself

Abstract

objectiveThe authors sought to assess for the presence of practice variation in the use of intraoperative transesophageal echocardiography (TEE) for open cardiac valve surgery.

designThis study was a retrospective cohort analysis.

settingThe administrative claims data used for this investigation were multi-institutional and a representative sample of commercially insured patients in the United States between 2010 and 2015.

participantsThe cohort consisted of adult patients, aged 18 years or older, undergoing open mitral valve (MV) or aortic valve (AV) surgery.

interventionsThis was an observational analysis without interventions. MEASUREMENTS AND MAIN

resultsOf 19,386 valve surgeries, 12,313 (64%) underwent AV replacement, 6,192 (32%) underwent MV repair or replacement, and 881 (<5%) underwent both MV and AV surgery. The overall rate of intraoperative TEE was 82% (95% confidence interval [CI]: 81%-82%), less frequently observed in AV procedures compared to MV or combined MV-AV procedures (80% v 85%, p < 0.001). Rates of intraoperative TEE claims varied markedly across U.S. states. After adjustment, the relative odds of an intraoperative TEE claim ranged across states from 0.26 (Louisiana, 95% CI: 0.18-0.36; p < 0.001) to 2.10 (North Carolina, 95% CI: 1.57-2.82; p < 0.001).

conclusionAmong adult patients undergoing open AV or MV surgery in the United States, 82% had a claim for an intraoperative TEE with marked variability across U.S. states. Increasing adherence to intraoperative TEE guidelines for valve surgery may represent an unrecognized opportunity to improve the quality of cardiac surgical care.

Indexed as

Guideline AdherencePractice Patterns, Physicians'AgedCardiac Surgical ProceduresEchocardiography, TransesophagealFemaleFollow-Up StudiesHeart Valve DiseasesHeart Valve ProsthesisHeart ValvesHumansMaleMonitoring, IntraoperativeReproducibility of ResultsRetrospective Studiesaortic valve surgerycardiovascular surgeryethics and policyguideline compliance and adherencehealth servicesintraoperative echocardiographymitral valve surgerytransesophageal echocardiography

Identifiers

PMID30174265
PMCPMC6310636

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.