0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

The Appropriateness of Use of Percutaneous Transluminal Coronary Angioplasty in New York State

Lee H. Hilborne, MD, MPH; Lucian L. Leape, MD; Steven J. Bernstein, MD, MPH; Rolla Edward Park, PhD; Mary E. Fiske, MD; Caren J. Kamberg, MSPH; Carol Pindar Roth, RN, MPH; Robert H. Brook, MD, ScD
JAMA. 1993;269(6):761-765. doi:10.1001/jama.1993.03500060061031.
Text Size: A A A
Published online

Objective.  —To determine the appropriateness of use of percutaneous transluminal coronary angioplasty (PTCA) in New York State.

Design.  —Retrospective randomized medical record.

Setting.  —Fifteen randomly selected hospitals in New York State that provide PTCA.

Patients.  —Random sample of 1306 patients undergoing PTCA in New York State in 1990.

Main Outcome Measures.  —Percentage of patients who underwent PTCA for indications rated appropriate, uncertain, and inappropriate.

Results.  —The majority of patients received PTCA for chronic stable angina, unstable angina, and in the post—myocardial infarction period (up to 3 weeks). Fifty-eight percent of PTCAs were rated appropriate; 38%, uncertain; and 4%, inappropriate. The inappropriate rate varied by hospital from 1% to 9% (P=.12); the uncertain rate, from 26% to 50% (P=.02); and the combined inappropriate and uncertain rate, from 29% to 57% (P<.001). There was no difference in appropriateness when the institutions were grouped by volume (fewer than 300 procedures annually or at least 300 procedures annually), location (upstate vs downstate), or by teaching status.

Conclusions.  —Few PTCAs were performed for inappropriate indications in New York State. However, the large number of procedures performed for indications that were rated uncertain as to their net benefit requires further study and justification at both clinical and policy levels.(JAMA. 1993;269:761-765)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();