Open access echocardiography has diagnostic yield similar to outpatient echocardiography and is highly rated by general practitioners and patients V.S. Mahadevan a, * , M. Earley b , B. McClements b a Regional Medical Cardiology Centre, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Ireland b Mater Infirmorum Hospital, Crumlin Road, Belfast BT14 6AB, Ireland Received 21 June 2003; received in revised form 4 January 2004; accepted 8 January 2004 Available online 17 July 2004 Abstract Background: Open access echocardiography is widely available to General Practitioners (GP). There is little data comparing the proportion of echocardiographic studies which are abnormal in open access series with that in hospital outpatient practice. This study compares the diagnostic yield from echocardiograms performed for similar indications by open access and hospital outpatient requested groups and assesses the attitudes of GPs and patients to open access echocardiography. Methods: The reports of 151 consecutive patients who had open access echocardiograms were analysed using predefined criteria for an abnormal study. The reports of 100 consecutive patients who had a new outpatient requested echocardiograms for similar indications were used as the control group. The attitudes of GPs and patients to the open access service were also assessed. Results: Fifty seven percent of patients in the open access group and 51% in the hospital requested group had abnormal studies (p>0.05). 92% of GPs who responded to the questionnaire thought the report was easy to understand while 69% thought it led to a change in patient management. 74% said a clinic referral would have been made without this service and 79% preferred a management strategy to be included in the report. 90% of patients had been informed of the result by their GP. Conclusions: Open access echocardiography has a diagnostic yield similar to echocardiograms requested on new hospital outpatients in a district general hospital setting. GPs and patients report high levels of satisfaction with this service. D 2004 Elsevier Ireland Ltd. All rights reserved. Keywords: Open access echocardiography; General practitioner; Patient 1. Introduction Open access echocardiography services allow General Practitioners (GP) to obtain a rapid echocardiographic assessment without the need for an outpatient consultation routinely. However, some groups have been cautious about providing open access echocardiography to general practi- tioners without an accompanying clinical assessment [1]. We and others have previously shown that general practi- tioners generally use open access stress electrocardiogra- phy appropriately and that referring GPs find it a useful service [2]. A number of groups have reported their experience of open access echocardiography [3–5]. How- ever, there is little data comparing the proportion of echocardiographic studies which are abnormal in open access series with that in hospital outpatient practice. A comparison of the diagnostic yield of studies requested for similar indications in these two settings should give some indication of how appropriately GPs use open access echocardiography. The main objective of this observational study was to compare the diagnostic yield from echocardiograms in an open access echocardiography service with that from echo- cardiograms requested for the same group of indications on new patients attending cardiology and medical outpatient clinics. The views of General Practitioners and patients views on the open access echocardiography service were assessed using questionnaires. 2. Patients and methods One hundred and fifty one consecutive patients who were referred for echocardiography on an open access basis 0167-5273/$ - see front matter D 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2004.01.042 * Corresponding author. Tel.: +28 90894905; fax: +28 90312907. E-mail address: vs.mahadevan@ntlworld.com (V.S. Mahadevan). www.elsevier.com/locate/ijcard International Journal of Cardiology 99 (2005) 389 – 393