January 13, 1983New England Journal of Medicine
Noninvasive Tests in the Initial Evaluation of Heart Murmurs in Children
Why the study?
Do noninvasive tests (ECG, chest radiography, M-mode echocardiography) change the clinical diagnosis in children referred for evaluation of a heart murmur?
Population
280 children older than one month, newly referred for evaluation of a heart murmur.
Comparison
Noninvasive tests following history and physical… vs Clinical evaluation alone
Design
Cohort
Authors
Discussion
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Member takes
Implication
Supports deferring routine noninvasive tests after expert evaluation; leaves open generalizability beyond single-center cohorts.
Structured PICO
Do noninvasive tests (ECG, chest radiography, M-mode echocardiography) change the clinical diagnosis in children referred for evaluation of a heart murmur?
P
Population
280 children older than one month, newly referred for evaluation of a heart murmur.
I
Intervention
Noninvasive tests (electrocardiography, chest radiography, and M-mode echocardiography) following history and physical examination
C
Comparator
Clinical evaluation alone (history and physical examination)
O
Outcome
Change in clinical diagnosis (presence vs absence of heart disease) after reviewing diagnostic tests
Routine noninvasive testing (ECG, chest radiography, echocardiography) is unlikely to change the clinical diagnosis made by a qualified pediatric cardiologist in children referred for a heart murmur.
Cite This Study
Newburger et al. (1983) studied this question.