PMID: 8609682Apr 17, 1996Paper

The association between local diagnostic testing intensity and invasive cardiac procedures

JAMA : the Journal of the American Medical Association
D E WennbergR B Keller

Abstract

To determine the extent to which geographic variation in invasive cardiac procedures can be explained by the variable use of diagnostic testing. A population-based cohort study using Medicare Part B data (physician services). Procedure data for all Medicare beneficiaries in northern New England. Twelve coronary angiography service areas were constructed for Medicare beneficiaries in northern New England. Age- and sex-adjusted utilization rates were developed for three procedure categories: total stress test, coronary angiography, and revascularization. Total stress tests were further stratified into nonimaging and imaging procedures (eg, thallium). Tests performed in follow-up to invasive procedures were excluded (eg, stress test following revascularizations). Linear regression was used to assess the relationship between procedure categories. A tight positive relationship was found between total stress test rates and the rates of subsequent coronary angiography (R2=0.61, P<.005). Most of the variance was explained by imaging stress tests (R2=0.50, P<.02). A strong relationship was found between coronary angiography and revascularization (R2=0.82, P<.001). Finally, a clear relationship between total stress tests and subsequent r...Continue Reading

Citations

Mar 1, 1997·Journal of General Internal Medicine·D E WennbergR B Keller
Jul 5, 2003·BMJ : British Medical Journal·Dave DavisMerrick Zwarenstein
Mar 17, 2005·JAMA : the Journal of the American Medical Association·Therese A StukelDavid E Wennberg
Jul 6, 2005·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Michelle M GrahamUNKNOWN APPROACH Investigators
Mar 1, 2007·PLoS Medicine·Raffaele BugiardiniFrans Van de Werf
Mar 16, 2007·Journal of General Internal Medicine·Matthew M DavisLakshmi K Halasyamani
Jul 12, 2008·Journal of General Internal Medicine·Grace A LinRita F Redberg
Aug 8, 2009·BMC Cardiovascular Disorders·Kathryn M KingWilliam A Ghali
Dec 1, 2005·Expert Review of Pharmacoeconomics & Outcomes Research·Robert S Rhodes, Andrew Resnick
Sep 22, 2009·Expert Review of Cardiovascular Therapy·Grace A Lin, Rita F Redberg
Sep 8, 2012·Journal of the American College of Radiology : JACR·Tracy OnegaAnna N A Tosteson
Jun 18, 2015·Academic Medicine : Journal of the Association of American Medical Colleges·Kira L RyskinaDeborah Korenstein
Jan 15, 2008·Cancer·Tracy OnegaDavid Goodman
Mar 24, 2010·AJR. American Journal of Roentgenology·Laurence ParkerVijay M Rao
Dec 6, 2005·Journal of the American College of Cardiology·Samuel Wann
Sep 28, 2005·International Journal of Cardiology·Dominic Y LeungCraig P Juergens
Nov 23, 2006·Journal of the American College of Cardiology·Pamela DouglasUNKNOWN Society for Vascular Medicine and Biology
Nov 11, 1999·Evaluation & the Health Professions·K ChangD B Nash
Aug 8, 2013·Circulation. Cardiovascular Interventions·William B BordenRita F Redberg
Feb 26, 2016·Journal of the American Heart Association·Jeffrey D CloughHarlan M Krumholz
Jun 20, 2017·Journal of Oncology Practice·Megan E V CaramTed A Skolarus
Sep 29, 2009·Journal of Clinical Pathology·S O MephamI Bates

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