Does assessment of pretest probability of disease improve the utility of echocardiography in suspected endocarditis in XXXX ?

@entity1 @entity166
OBJECTIVE: To compare the yield rate (YR) of echocardiography when evaluating @entity1 with suspected @entity166 ( @entity166 ) in both the actual clinical setting and in the hypothetic setting where strict clinical criteria are applied. Study design Medical records of 101 @entity1 undergoing echocardiography for suspected @entity166 were reviewed. Echocardiograms with positive findings were identified and the actual diagnostic YR was calculated. With the use of clinical criteria proposed by von Reyn (VR), the probability of @entity166 was retrospectively classified as (1) rejected, (2) possible, or (3) probable. Theoretic YR of echocardiography was calculated for each classification. RESULTS: The actual YR of echocardiography was 12% (12/101). The YR of echocardiography by VR class was 0% in rejected, 20% in possible, and 80% in probable cases (chi(2) = 55.1, P <.0001). Echocardiography did not change the probability of @entity166 in any @entity1 classified as rejected, but allowed reassignment of disease probability in a significant proportion of @entity1 with possible or probable @entity166 . CONCLUSIONS: The YR of echocardiography was significant when clinical probability of @entity166 was intermediate-to-high, and low, with marginal clinical utility, when clinical probability was low. Strict pretest assessment of disease probability may lead to more effective utilization of echocardiography in this population.
