Abstract:
BACKGROUND:Report cards of risk-adjusted mortality rates of individual cardiac surgeons have been publicly available in New York State since 1991. A survey of New York cardiologists in 1996 found that these report cards had little effect on their referral recommendations to cardiac surgeons. It is unknown whether the influence of report cards on referral behavior has changed over time. METHODS AND RESULTS:We surveyed cardiologists in New York State in 2011 to determine their awareness of cardiac surgeon report cards, their use of the report card in formulating judgments about the quality of cardiac surgeons and selecting cardiac surgeons for referral of patients, and discussion of the report with patients in need of cardiac surgery. The relation between demographic (age, sex) and professional (teaching, board certification, faculty appointment, general cardiology practice, and hospital employee) characteristics and the influence of report cards on referral decisions was assessed using χ(2) for categorical variables and t test for continuous variables. Multivariable logistic regression models were created to determine the independent association of any variable with P<0.1 on univariate analysis. Almost all (94%) cardiologists were aware of report cards of cardiac surgeons. The influence of the report cards on cardiologists' referral decisions was limited, with 25% of cardiologists reporting a moderate or substantial influence on referral decisions. The report card was not discussed with any patients by 71% of cardiologists. The mean age of cardiologists reporting moderate or substantial influence of report cards was 58 years compared with 54 years for those who reported no/little influence (P=0.012). Fewer cardiologists who reported moderate or substantial influence were board certified (91% versus 99%; P=0.003). On multivariate analysis, general cardiology practice and employment by a hospital were independently associated with greater report card influence (odds ratio, 1.03; 95% confidence interval, 1.01-1.05; P=0.13). CONCLUSIONS:After 20 years of public reporting and almost universal awareness of cardiac surgeon report cards, in 2011, cardiologists in New York State made little use of this information and rarely discussed it with patients at the time of referral for cardiac surgery.
journal_name
Circ Cardiovasc Qual Outcomesjournal_title
Circulation. Cardiovascular quality and outcomesauthors
Brown DL,Epstein AM,Schneider ECdoi
10.1161/CIRCOUTCOMES.113.000506subject
Has Abstractpub_date
2013-11-01 00:00:00pages
643-8issue
6eissn
1941-7713issn
1941-7705pii
CIRCOUTCOMES.113.000506journal_volume
6pub_type
杂志文章abstract:BACKGROUND:Rehospitalizations after acute myocardial infarction for unplanned coronary revascularization and unstable angina (UA) are common. However, despite the inclusion of these events in composite end points of many clinical trials, their association with health status has not been studied. METHODS AND RESULTS:We...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND:Percutaneous coronary intervention (PCI) for stable coronary artery disease does not reduce the risk of death and myocardial infarction compared with optimal medical therapy (OMT), but many patients think otherwise. PCI Choice, a decision aid (DA), was designed for use during the clinical visit and includes ...
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journal_title:Circulation. Cardiovascular quality and outcomes
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doi:10.1161/CIRCOUTCOMES.113.000691
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journal_title:Circulation. Cardiovascular quality and outcomes
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doi:10.1161/CIRCOUTCOMES.111.961391
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doi:10.1161/CIRCOUTCOMES.111.964379
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pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.113.000497
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-01-01 00:00:00
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
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更新日期:2018-07-01 00:00:00
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journal_title:Circulation. Cardiovascular quality and outcomes
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.109.850883
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doi:10.1161/CIRCOUTCOMES.108.811828
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journal_title:Circulation. Cardiovascular quality and outcomes
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doi:10.1161/CIRCOUTCOMES.113.000299
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journal_title:Circulation. Cardiovascular quality and outcomes
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.111.960740
更新日期:2011-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.117.004414
更新日期:2019-01-01 00:00:00
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journal_title:Circulation. Cardiovascular quality and outcomes
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pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.115.001789
更新日期:2015-11-01 00:00:00
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-11-01 00:00:00
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doi:10.1161/CIRCOUTCOMES.116.003074
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journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.114.001613
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