- This study did not model a strategy of observation only.
- If pediatrician auscultatory skills improve to 91% sensitivity (from
86%), selective referral to ECHO would cost $66,000/case identified
and detect almost all of the pathologic lesions.
- No distinction was made between the various underlying lesions.
- This study did not model health care costs of treating the carious
- If prevalence increases to 14%, referral of all murmurs to ECHO would
cost $18,000/case. This may be a reasonable strategy in special populations.
MS, Kimball TR, Tsevat J, Mrus JM, and Kotagal UR. Evaluation of heart
murmurs in children: Cost-effectiveness and practical implications.
Journal of Pediatrics 2002;141, 504-11.