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Preoperative Echocardiography for Noncardiac Surgery
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
I commend Dr. Halm and his colleagues in the Study of Perioperative Ischemia Research Group for giving us valuable insight into the role of echocardiography in preoperative evaluations [1]. The comprehensive tables documenting the sensitivity, specificity, and predictive values of ejection fractions from echocardiograms illustrate that high technology is not always better than a thorough history and physical. However, I was disappointed that the authors did not delineate the manner in which information from the traditional clinical evaluation was incorporated into their clinical model. The authors state that several risk classification schemes were determined for each patient, but they do not state how the quantitative clinical scales were used. Therefore, I wonder why the diagnostic value of echocardiography was not compared with the diagnostic predictability of the preoperative risking schemes of the commonly used Goldman cardiac risk index [2], Detsky risk index [3], or other indexes [4, 5].
A comparison of the diagnostic value of echocardiography with that of currently used clinical diagnostic risking scales would help the working clinician better determine whether the traditional preoperative evaluation is really all that is needed.
Ted Palen, MD, PhD
University of Colorado Health Sciences Center; Denver, CO 80220
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
