Hyland PM, Xu J, Shen C, et al. - Findings among Medicare beneficiaries with multiple transthoracic echocardiography (TTEs) in a single large healthcare system revealed that following the index TTE, the median TTE utilization was 0.72 TTEs/person/year, although this varied widely.

• TTE reports from a single integrated healthcare system were linked to 100% Medicare fee-for-service claims from 1 January 2005 to 31 December 2017.

• A median follow-up of 4.9 years revealed that 15,870 people underwent overall 63,535 TTEs (range 2–55/person).

• Lower TTE use was seen in older people (relative risk (RR) for 10-year increment in age, 0.91), women (RR 0.97) and non-white persons (RR 0.95).

• The lowest relative use of TTE was particularly seen among Black women (RR 0.92).

• Only heart failure and chronic obstructive pulmonary disease were linked with increased TTE use post-multivariable adjustment, with RR 1.04 and 1.05, respectively.