ArticleJAMA cardiology2016
Cardiac Stress Test Trends Among US Patients Younger Than 65 Years, 2005-2012.
Article in JAMA cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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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.
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.
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Who cites it
10 citing papers in PubMed.
- Clinical Care Delivery in Chest Pain Patients Without an Acute Coronary Syndrome-A Retrospective Cohort Study.Journal of clinical medicine · 2025Article
- Acupuncture Dosage and Its Correlation with Effectiveness in Patients with Chronic Stable Angina: A Systematic Review and Meta-Analysis of Randomized Controlled Trial.Journal of pain research · 2025Review
- Role of non-invasive coronary imaging in stable angina.Global cardiology science & practice · 2024Review
- Hemodynamic response and safety of vasodilator stress cardiovascular magnetic resonance in patients with permanent pacemakers or implantable cardioverter-defibrillators.Journal of cardiovascular electrophysiology · 2022Article
- Article
- Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry.European heart journal. Cardiovascular Imaging · 2021Article
- Limited Use of Outpatient Stress Testing in Young Patients With Atypical Chest Pain.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2018Article
- The new clinical standard of integrated quadruple stress echocardiography with ABCD protocol.Cardiovascular ultrasound · 2018Review
- Clinical Outcomes After Cardiac Stress Testing Among US Patients Younger Than 65 Years.Journal of the American Heart Association · 2018Observational
- Imaging to Assess Ischemic Heart Disease in Women.Current atherosclerosis reports · 2018Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
importanceAfter a period of rapid growth, use of cardiac stress testing has recently decreased among Medicare beneficiaries and in a large integrated health system. However, it is not known whether declines in cardiac stress testing are universal or are confined to certain populations.
objectiveTo determine trends in rates of cardiac stress testing among a large and diverse cohort of commercially insured patients. DESIGN, SETTING, AND
participantsA serial cross-sectional study with time trends was conducted using administrative claims from all members aged 25 to 64 years belonging to a large, national managed care company from January 1, 2005, to December 31, 2012. Linear trends in rates were determined using negative binomial regression models with procedure count as the dependent variable, calendar quarter as the key independent variable, and the size of the population as a logged offset term. Data analysis was performed from January 1, 2005, to December 31, 2012. MAIN OUTCOMES AND MEASURES: Age- and sex-adjusted rates of cardiac stress tests per calendar quarter (reported as number of tests per 100 000 person-years).
resultsA total of 2 085 591 cardiac stress tests were performed among 32 921 838 persons (mean [SD] age, 43.2 [10.9] years; 16 625 528 women [50.5%] and 16 296 310 [49.5%] men; 7 604 945 nonwhite [23.1%]). There was a 3.0% increase in rates of cardiac stress testing from 2005 (3486 tests; 95% CI, 3458-3514) to 2012 (3589 tests; 95% CI, 3559-3619; P = .01 for linear trend). Use of nuclear single-photon emission computed tomography decreased by 14.9% from 2005 (1907 tests; 95% CI, 1888-1926) to 2012 (1623 tests; 95% CI, 1603-1643; P = .03). Use of stress echocardiography increased by 27.8% from 2005 (709 tests; 95% CI, 697-721) to 2012 (906 tests; 95% CI, 894 to 920; P < .001). Use of exercise electrocardiography increased by 12.5% from 2005 (861 tests; 95% CI, 847-873) to 2012 (969 tests; 95% CI, 953-985; P < .001). Use of other stress testing modalities increased 65.5% from 2006 (55 tests; 95% CI, 51-59) to 2012 (91 tests; 95% CI, 87-95; P < .001). For individuals aged 25 to 34 years, rates of cardiac stress testing increased 59.1% from 2005 (543 tests; 95% CI, 532-554) to 2012 (864 tests; 95% CI, 852-876; P < .001). For individuals aged 55 to 64 years, rates of cardiac stress testing decreased by 12.3% from 2005 (7894 tests; 95% CI, 7820-7968) to 2012 (6923 tests; 95% CI, 6853-6993; P < .001). CONCLUSIONS AND RELEVANCE: In contrast to declines in the use of cardiac stress testing in some health care systems, we observed a small increase in its use among a nationally representative cohort of commercially insured patients. Our findings suggest that observed trends in the use of cardiac stress testing may have been driven more by unique characteristics of populations and health systems than national efforts to reduce the overuse of testing.
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Registered trials
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