James Willis, Casey L Johnson, Samuel Krasner, William Woodward, Annabelle McCourt, Cameron Dockerill, Katrin Balkhausen, Badrinathan Chandrasekaran, Attila Kardos, Nikant Sabharwal, Soroosh Firoozan, Rizwan Sarwar, Roxy Senior, Rajan Sharma, Kenneth Wong, Maria Paton, Jamie O'Driscoll, David Oxborough, Keith Pearce, Shaun Robinson, Adora Mo Wah Yau, Daniel X Augustine, Paul Leeson
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This study, as part of the National Review of Stress Echocardiography Practice (BSE N-STEP), aimed to evaluate current stress echo workforce structures and test outcomes across a group of UK hospitals to inform future workforce planning.</p><p><strong>Results: </strong>Data were analysed from 8506 stress echocardiograms, conducted between September 2020 and June 2023 across 34 UK hospitals. Based on the supervising workforce, stress echocardiograms were allocated into either a doctor-led (DL) or cardiac physiologist/scientist and nurse-led (CNL) model. 56.9% of stress echocardiograms were DL, while 42.7% were conducted under a CNL model. Physiologists/scientists were the most frequently involved staff (81.9%). The primary indication for stress echocardiography was ischaemia evaluation (89.4%). Dobutamine stress echocardiography was more common in DL services (63.0 vs. 56.3%, p < 0.001), while CNL services performed more exercise stress echocardiography (42.8 vs. 36.4%, p < 0.001). Test positivity rates were similar between DL and CNL models (17.1 vs. 17.7%, p = ns), though the CNL group had a lower complication rate (2.2 vs. 5.3%, p < 0.001). Reporting of stress echocardiograms remained consultant-led in 82% of cases, but physiologist/scientist-led reporting showed an increase over time. Training was primarily provided to registrars/fellows (60.2%), with physiologist/scientist trainees accounting for 32.4%.</p><p><strong>Conclusions: </strong>This study provides a contemporary overview of stress echocardiography workforce models in the UK, highlighting the increasing role of cardiac physiologists and scientists in supervising and reporting stress echocardiography. Despite these shifts, consultant cardiologists remain central to stress echo reporting. The findings support the integration of multidisciplinary workforce models to enhance service efficiency. These insights will aid in future workforce planning and training strategies to optimise stress echocardiography service provision across the NHS.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"22"},"PeriodicalIF":2.4000,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512890/pdf/","citationCount":"0","resultStr":"{\"title\":\"Contemporary review of stress echocardiography workforce within the UK: an EVAREST/BSE NSTEP study.\",\"authors\":\"James Willis, Casey L Johnson, Samuel Krasner, William Woodward, Annabelle McCourt, Cameron Dockerill, Katrin Balkhausen, Badrinathan Chandrasekaran, Attila Kardos, Nikant Sabharwal, Soroosh Firoozan, Rizwan Sarwar, Roxy Senior, Rajan Sharma, Kenneth Wong, Maria Paton, Jamie O'Driscoll, David Oxborough, Keith Pearce, Shaun Robinson, Adora Mo Wah Yau, Daniel X Augustine, Paul Leeson\",\"doi\":\"10.1186/s44156-025-00088-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Stress echocardiography is a key imaging modality for assessing coronary artery disease in the UK. Traditionally, stress echo services were led by consultant cardiologists, but evolving workforce models have increased the involvement of cardiac physiologists and scientists. This study, as part of the National Review of Stress Echocardiography Practice (BSE N-STEP), aimed to evaluate current stress echo workforce structures and test outcomes across a group of UK hospitals to inform future workforce planning.</p><p><strong>Results: </strong>Data were analysed from 8506 stress echocardiograms, conducted between September 2020 and June 2023 across 34 UK hospitals. Based on the supervising workforce, stress echocardiograms were allocated into either a doctor-led (DL) or cardiac physiologist/scientist and nurse-led (CNL) model. 56.9% of stress echocardiograms were DL, while 42.7% were conducted under a CNL model. Physiologists/scientists were the most frequently involved staff (81.9%). The primary indication for stress echocardiography was ischaemia evaluation (89.4%). Dobutamine stress echocardiography was more common in DL services (63.0 vs. 56.3%, p < 0.001), while CNL services performed more exercise stress echocardiography (42.8 vs. 36.4%, p < 0.001). Test positivity rates were similar between DL and CNL models (17.1 vs. 17.7%, p = ns), though the CNL group had a lower complication rate (2.2 vs. 5.3%, p < 0.001). Reporting of stress echocardiograms remained consultant-led in 82% of cases, but physiologist/scientist-led reporting showed an increase over time. Training was primarily provided to registrars/fellows (60.2%), with physiologist/scientist trainees accounting for 32.4%.</p><p><strong>Conclusions: </strong>This study provides a contemporary overview of stress echocardiography workforce models in the UK, highlighting the increasing role of cardiac physiologists and scientists in supervising and reporting stress echocardiography. Despite these shifts, consultant cardiologists remain central to stress echo reporting. 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引用次数: 0
摘要
背景:在英国,应激超声心动图是评估冠状动脉疾病的关键成像方式。传统上,压力回声服务由咨询心脏病专家领导,但不断发展的劳动力模式增加了心脏生理学家和科学家的参与。本研究作为全国压力超声心动图实践回顾(BSE N-STEP)的一部分,旨在评估英国医院当前的压力回声劳动力结构和测试结果,为未来的劳动力规划提供信息。结果:分析了2020年9月至2023年6月在英国34家医院进行的8506张压力超声心动图的数据。根据监护人员,压力超声心动图被分配到医生主导(DL)或心脏生理学家/科学家和护士主导(CNL)模型。56.9%的应激超声心动图为DL, 42.7%为CNL模型。生理学家/科学家是最常涉及的员工(81.9%)。应激超声心动图的主要指征是缺血评估(89.4%)。多巴酚丁胺应激超声心动图在DL服务中更常见(63.0 vs. 56.3%, p)。结论:本研究提供了英国应激超声心动图劳动力模型的当代概述,强调心脏生理学家和科学家在监督和报告应激超声心动图方面的作用越来越大。尽管有这些变化,心脏病专家顾问仍然是压力回声报告的核心。研究结果支持多学科劳动力模型的整合,以提高服务效率。这些见解将有助于未来的劳动力规划和培训策略,以优化整个NHS的压力超声心动图服务提供。
Contemporary review of stress echocardiography workforce within the UK: an EVAREST/BSE NSTEP study.
Background: Stress echocardiography is a key imaging modality for assessing coronary artery disease in the UK. Traditionally, stress echo services were led by consultant cardiologists, but evolving workforce models have increased the involvement of cardiac physiologists and scientists. This study, as part of the National Review of Stress Echocardiography Practice (BSE N-STEP), aimed to evaluate current stress echo workforce structures and test outcomes across a group of UK hospitals to inform future workforce planning.
Results: Data were analysed from 8506 stress echocardiograms, conducted between September 2020 and June 2023 across 34 UK hospitals. Based on the supervising workforce, stress echocardiograms were allocated into either a doctor-led (DL) or cardiac physiologist/scientist and nurse-led (CNL) model. 56.9% of stress echocardiograms were DL, while 42.7% were conducted under a CNL model. Physiologists/scientists were the most frequently involved staff (81.9%). The primary indication for stress echocardiography was ischaemia evaluation (89.4%). Dobutamine stress echocardiography was more common in DL services (63.0 vs. 56.3%, p < 0.001), while CNL services performed more exercise stress echocardiography (42.8 vs. 36.4%, p < 0.001). Test positivity rates were similar between DL and CNL models (17.1 vs. 17.7%, p = ns), though the CNL group had a lower complication rate (2.2 vs. 5.3%, p < 0.001). Reporting of stress echocardiograms remained consultant-led in 82% of cases, but physiologist/scientist-led reporting showed an increase over time. Training was primarily provided to registrars/fellows (60.2%), with physiologist/scientist trainees accounting for 32.4%.
Conclusions: This study provides a contemporary overview of stress echocardiography workforce models in the UK, highlighting the increasing role of cardiac physiologists and scientists in supervising and reporting stress echocardiography. Despite these shifts, consultant cardiologists remain central to stress echo reporting. The findings support the integration of multidisciplinary workforce models to enhance service efficiency. These insights will aid in future workforce planning and training strategies to optimise stress echocardiography service provision across the NHS.
期刊介绍:
Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.