Among the 10 group practices, ECG ordering varied from 0.5% to 9.6% of visits (adjusted rates, 0.8%-8.6%). Results Electrocardiograms were ordered in 4.4% of visits to patients without reported cardiac disease. Logistic regression evaluated additional predictors of ECG ordering. Adjusted rates of ECG ordering accounted for patient age, sex, and 5 key diagnoses. Included were 69 921 patients making 190 238 visits to 125 primary care providers. To focus on screening or routine ECGs, patients with known cardiac disease or suggestive symptoms were excluded, as were providers with fewer than 200 annual patient visits. Methods We used 2 computerized billing systems to measure ECG ordering at visits to providers in 10 internal medicine group practices affiliated with a large, urban teaching hospital from October 1, 1996, to September 30, 1997. Shared Decision Making and Communicationīackground Lack of practical consensus regarding routine electrocardiogram (ECG) ordering in primary care led us to hypothesize that nonclinical variations in ordering would exist among primary care providers.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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