Evidence map›Paper›PMID 21540420›Full record

ArticleJAMA2011

Coronary revascularization trends in the United States, 2001-2008.

Andrew J Epstein, Daniel Polsky, Feifei Yang, Lin Yang, Peter W Groeneveld

Registry-linked trialAbstract read
In one paragraph

Article in JAMA, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04741035 (Effectiveness of Modified Sternal Precautions Versus Conventional Sternal Precautions in Improving Physical Function After Sternotomy), which is not on this map. Cited by 146 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
146citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04741035 nacompletednot on this mapstarted 2020, after this paper: background citation

Effectiveness of Modified Sternal Precautions Versus Conventional Sternal Precautions in Improving Physical Function After Sternotomy

TypeinterventionalSponsorRiphah International UniversityRan2020 to 2021Enrolled40ConditionsCardiovascular DiseasesArmsModified sternal precautions, Conventional sternal precautions
3 · Its place in the literature

Who cites it

146 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Large-scale experience with an anchorless vascular closure device in a real-life clinical setting.Clinical research in cardiology : official journal of the German Cardiac Society · 2015
    Trial
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  6. Patient preferences for coronary artery bypass graft surgery or percutaneous intervention in multivessel coronary artery disease.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2013
    Trial
  7. Review
  8. Review
  9. Observational
  10. Article
  11. Article
  12. Review
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  18. Using machine learning to predict perfusionists' critical decision-making during cardiac surgery.Computer methods in biomechanics and biomedical engineering. Imaging & visualization · 2022
    Article
  19. Article
  20. Article

86 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Andrew J EpsteinDepartment of Veterans Affairs' Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania, USA.
Daniel Polsky
Feifei Yang
Lin Yang
Peter W Groeneveld

Funding

Implications of cardiovascular technology diffusion among Medicare beneficiariesR01HL086919 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI GROENEVELD, PETER W. · 2007 to 2009
$1.6M
COMPARATIVE EFFECTIVENESS OF CARDIOVASCULAR DEVICES AND MEDICARE COST GROWTHR01HS018403 · AHRQ · UNIVERSITY OF PENNSYLVANIA · PI GROENEVELD, PETER W. · 2009 to 2011
$1.2M
AHRQ HHS 1R01HS018403AHRQ HHS R01 HS018403NHLBI NIH HHS 1R01HL086919NHLBI NIH HHS R01 HL086919
6 · The paper itself

Abstract

contextCoronary revascularization is among the most common hospital-based major interventional procedures performed in the United States. It is uncertain how new revascularization technologies, new clinical evidence from trials, and updated clinical guidelines have influenced the volume and distribution of coronary revascularizations over the past decade.

objectiveTo examine national time trends in the rates and types of coronary revascularizations. DESIGN, SETTING, AND PATIENTS: A serial cross-sectional study with time trends of patients undergoing coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions (PCIs) between 2001 and 2008 at US hospitals in the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, which reports inpatient coronary revascularizations. These data were supplemented by Medicare outpatient hospital claims.

main outcome measuresAnnual procedure rates of coronary revascularizations, CABG surgery, and PCI.

resultsA 15% decrease (P < .001) in the annual rate of coronary revascularizations was observed from 2001-2002 to 2007-2008. The annual CABG surgery rate decreased steadily from 1742 (95% confidence interval [CI], 1663-1825) CABG surgeries per million adults per year in 2001-2002 to 1081 (95% CI, 1032-1133) CABG surgeries per million adults per year in 2007-2008 (P < .001), but PCI rates did not significantly change (3827 [95% CI, 3578-4092] PCI per million adults per year in 2001-2002 vs 3667 [95% CI, 3429-3922] PCI per million adults per year in 2007-2008, P = .74). Between 2001 and 2008, the number of hospitals in the Nationwide Inpatient Sample providing CABG surgery increased by 12% (212 in 2001 vs 241 in 2008, P = .03), and the number of PCI hospitals increased by 26% (246 in 2001 vs 331 in 2008, P < .001). The median CABG surgery caseload per hospital decreased by 28% (median [interquartile range], 253 [161-458] in 2001 vs 183 [98-292] in 2008; P < .001) and the number of CABG surgery hospitals providing fewer than 100 CABG surgeries per year increased from 23 (11%) in 2001 to 62 (26%) in 2008 (P < .001).

conclusionsIn US hospitals between 2001 and 2008, a substantial decrease in CABG surgery utilization rates was observed, but PCI utilization rates remained unchanged.

Indexed as

AgedAngioplastyCoronary Artery BypassCross-Sectional StudiesDrug-Eluting StentsFemaleHealth Care SurveysHospitalsHumansInsurance Claim ReviewMaleMedicareMiddle AgedMyocardial RevascularizationUnited States

Identifiers

PMID21540420
PMCPMC3164857

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.