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NCD Alliance says U.S., Canada, E.U. stalling efforts to fight NCDs

November 13, 2017

Dr. Wijeysundera and his colleagues have previously shown that if patients had at least one risk factor for postoperative cardiac complications, they had better survival after surgery if they had undergone stress testing before their operation. Despite these better outcomes with stress testing, physicians in Ontario are 50 per cent more likely to order an echocardiogram before surgery, perhaps because they are often easier to order quickly.

Dr. Wijeysundera said there are some potential reasons for these findings. Since echocardiograms do not perform that well in distinguishing between high-risk and low-risk patients, physicians may have been incorrectly reassured that some high-risk patients could safely undergo surgery with no additional specialized care.

In addition, some physicians may have incorrectly thought that some low-risk patients needed specialized care and therefore given them unnecessary and potentially harmful interventions.

"If echocardiography results in patients having a better chance of surviving after major surgery, its increased use is justified," Dr. Wijeysundera said. "If it does not, the relatively common use of echocardiography represents an unnecessary healthcare cost that may also unnecessarily delay scheduled surgeries."

Source: St. Michael's Hospital