Evidence map›Paper›PMID 33719490›Full record

ArticleCirculation. Cardiovascular quality and outcomes2021

Trends in Coded Indications for Percutaneous Coronary Interventions in Medicare and the Veterans Affairs After Implementation of Hospital-Level Reporting of Appropriate Use Criteria.

Elias J Dayoub, Ashwin S Nathan, Sameed Ahmed M Khatana, Rishi K Wadhera, Daniel M Kolansky, Robert W Yeh, Jay Giri, Peter W Groeneveld

Open access · bronzeAbstract read
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. Review
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

8 authors at 3 institutions in 2 countries.

Elias J DayoubMichael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA (E.J.D., J.G., P.W.G.).
Ashwin S NathanCenter for Cardiovascular Outcomes, Quality, and Evaluative Research (E.J.D., A.S.N., S.A.M.K., J.G., P.W.G.), University of Pennsylvania, Philadelphia.
Sameed Ahmed M KhatanaCenter for Cardiovascular Outcomes, Quality, and Evaluative Research (E.J.D., A.S.N., S.A.M.K., J.G., P.W.G.), University of Pennsylvania, Philadelphia.
Rishi K WadheraRichard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (R.K.W., R.W.Y.).
Daniel M KolanskyDivision of Cardiovascular Medicine (E.J.D., A.S.N., S.A.M.K., D.M.K., J.G.), Hospital of the University of Pennsylvania, Philadelphia.
Robert W YehRichard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (R.K.W., R.W.Y.).
Jay GiriMichael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA (E.J.D., J.G., P.W.G.).
Peter W GroeneveldMichael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA (E.J.D., J.G., P.W.G.).
Cardiovascular Institute of the South · USHospital of the University of Pennsylvania · USDeaconess Hospital · US

Funding

Association of Health Insurance with Access to Cardiovascular CareK23HL153772 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KHATANA, SAMEED AHMED MUSTAFA · 2020 to 2024
$981k
NHLBI NIH HHS K23 HL153772
6 · The paper itself

Abstract

backgroundIn 2009, the American College of Cardiology and American Heart Association published Appropriate Use Criteria for Coronary Revascularization (AUC) to aid patient selection for percutaneous coronary intervention (PCI). The subsequent decline in inappropriate PCIs was interpreted as a success of AUC. However, there are concerns clinicians reclassify nonacute PCIs to acute indications to fulfill AUC.

methodsA longitudinal, observational difference-in-differences analysis was performed using administrative claims from US Department of Veterans Affairs (VA) beneficiaries coenrolled in Medicare and from a national random sample of Medicare beneficiaries, undergoing PCI from September 30, 2009, to December 31, 2013. Non-VA hospitals participating in the American College of Cardiology CathPCI registry began receiving AUC reports in 2011, while VA hospitals did not receive reports, serving as quasiexperimental and control cohorts, respectively. We measured the proportion of PCIs coded for acute myocardial infarction, unstable angina, and nonacute coronary syndrome indications by quarter.

resultsThere were 87 464 and 30 251 PCIs performed in the Medicare and VA cohorts, respectively. In Medicare, proportion of PCIs coded for acute myocardial infarction and unstable angina changed from 31.9% and 12.6% in quarter 4 2009 to 41.0% and 10.5% in quarter 4 2013, an associated 2.00% (95% CI, 1.56%-2.44%;

conclusionsAfter introduction of AUC assessments and reporting, we observed comparable increases in coding for acute myocardial infarction and corresponding decreases in coding for unstable angina and nonacute coronary syndrome indications among national cohorts of Medicare and VA enrollees. The provision of appropriate use reporting did not appear to have a substantial impact on the proportion of PCIs coded for acute indications during this study period.

Indexed as

Myocardial InfarctionPercutaneous Coronary InterventionVeteransAgedHospitals, VeteransHumansMedicareRegistriesUnited Statesacute coronary syndromecoronary artery diseaseMedicaremyocardial infarctionpercutaneous coronary intervention

Identifiers

PMID33719490
PMCPMC9125496
OpenAlexW3138276954

What OpenQuestion holds

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Registered trials

None linked

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.