Clinical Report: Diagnostic Testing and Experience in Pediatric Cardiology
Overview
In a retrospective study of 7,918 new pediatric cardiology visits for chest pain, dizziness/syncope, palpitations, or murmur, 1,293 patient-family experience surveys were completed. Top-box provider ratings were common and did not differ significantly by referral complaint. Individual cardiac tests were not associated with top-box ratings, and ratings did not differ significantly across testing-pattern groups.
Background
Common pediatric cardiology referrals include chest pain, syncope, palpitations, and murmur, although cardiac pathology underlying these presentations is uncommon. These referrals can be associated with caregiver anxiety and substantial healthcare resource use and cost. Appropriate use criteria and standardized assessment plans have been developed to support clinically indicated testing and reduce unwarranted studies. This study examined the association between cardiac testing and patient-family experience scores after new cardiology visits.
The retrospective chart review included new cardiology referral visits at Cincinnati Children’s Hospital Medical Center from January 1, 2022, through December 31, 2023.
Eligible complaints were chest pain, dizziness/syncope, palpitations, and murmur; encounters without associated patient-family experience scores were excluded.
Of 7,080 families offered a survey, 1,293 returned a completed survey, for an overall response rate of 16%.
Murmur was the most common referral complaint (41%), followed by dizziness/syncope (26%), chest pain (18%), and palpitations (15%).
Provider ratings were top-box in 91% of completed surveys; rates ranged from 89% for chest pain to 93% for murmur, with no statistically significant difference by complaint (p = 0.09).
Survey domains of provider respect, provider communication, and time spent with the provider also showed no statistically significant differences across referral complaints. The supplied results do not report findings by testing status.
Clinical Implications
In this cohort, top-box provider ratings and the reported survey domains did not differ significantly across referral complaints. The study also reported no association between individual cardiac tests and top-box ratings, and no significant variation across groups defined by testing pattern (p = 0.31).
Conclusion
Most completed surveys gave top-box provider ratings, with no statistically significant variation by referral complaint. Individual cardiac tests were not associated with top-box ratings, and ratings did not differ significantly across testing-pattern groups.
