This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Cardiac Diagnostic Tests  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The article by Devereaux and colleagues¹ documenting the underuse of validated cardiac risk indices by medical consultants evaluating patients undergoing noncardiac surgery highlights the real "bench to bedside" challenge we face. The science of cardiac risk assessment has come a long way, with over 20 years of published studies on cardiac risk assessment, validation of numerous risk prediction rules, and promulgation of several national guidelines. However, there appears to be very limited diffusion of these findings into real-world practice, even in the university teaching hospitals studied in this report.

I was particularly dismayed, but not surprised, that plain echocardiography was the most commonly ordered perioperative screening test. We have previously shown that resting transthoracic echocardiography does not identify patients at high risk for perioperative cardiac death, myocardial infarction, or unstable angina.² In addition, routine echocardiographic screening did not provide any incremental prognostic information about the risk of postsurgical congestive heart . . . [Full Text of this Article]