Choose Wisely ASE Survey

Thank you for taking part in ASE and ABIM Foundation’s Choosing Wisely® campaign. ASE is now in the process of selecting cardiovascular patient procedures to focus on in the ABIM’s Foundation’s Choosing Wisely® campaign. Your responses will help in our efforts to select these important elements. ASE is being careful to follow the Echo AUC guidelines as a starting point. If you have any questions regarding our AUC guidelines, please consult the document here: AUC guidelines

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1. Please identify Five Things to Question — tests or procedures commonly used in the field whose necessity should be questioned and discussed.

Please identify Five Things to Question — tests or procedures commonly used in the field whose necessity should be questioned and discussed. To diagnose infective endocarditis with a low pretest probability (e.g., transient fever, known alternative source of infection, or negative blood cultures/atypical pathogen for endocarditis) (AUC 107)

Ventricular function: Routine surveillance of ventricular function with known CAD and no change in clinical status or cardiac exam (AUC 11)

Transient fever without evidence of bacteremia or a new murmur (AUC 53)

Cardiac trauma: routine evaluation in the setting of mild cardiac trauma with no electrocardiographic changes or biomarker elevation (AUC 33)

Murmur or click: Initial evaluation when there are no other symptoms or signs of valvular or structural heart disease (AUC 35)

Routine perioperative evaluation of ventricular function with no symptoms or signs of cardiovascular disease (AUC 13)

Native valve regurgitation: Routine surveillance (<3 y) of mild valvular regurgitation without a change in clinical status or cardiac exam (AUC 43)

Stress Echocardiography for Detection of CAD/Risk Assessment: Asymptomatic (Without Ischemic Equivalent - Low Global CAD Risk) (AUC124)

Murmur or click: Re-evaluation in a patient without valvular disease on prior echocardiogram and no change in clinical status or cardiac exam (AUC 36)

Routine use of TEE when a diagnostic TTE is reasonably anticipated to resolve all diagnostic and management concerns (AUC 100)

Low-Risk Surgery With Stress Echocardiography: Perioperative evaluation for risk assessment (AUC 154)

Evaluation of Ischemic Equivalent (Nonacute) With Stress Echocardiography - Low pretest probability of CAD, ECG interpretable and able to exercise (AUC 114)

Devices: Routine surveillance (≥1 y) of implanted device without a change in clinical status or cardiac exam (AUC 80)

Evaluation for cardiovascular source of embolus with a known cardiac source in which a TEE would not change management (AUC 111)

Native valve regurgitation: Routine surveillance of trace valvular regurgitation (AUC 42)

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