The appropriateness of performing coronary angiography and coronary artery revascularization in a Swedish population
A. Bengtson, J. Herlitz, T. Karlsson, G. Brandrup-Wognsen and A. Hjalmarson
Division of Cardiology, Wallenberg Laboratory, University of Goteborg, Sweden.
OBJECTIVE--To evaluate the appropriateness of performing coronary
angiography and revascularization in a Swedish population.
DESIGN--Prospective population study of questionnaires and medical records.
SETTING--All the hospitals in southwestern Sweden that perform coronary
angiography and revascularization. PATIENTS--Random sample of 831 patients
(with chronic stable angina) on the waiting list for coronary angiography
or revascularization in southwestern Sweden in September 1990. MAIN OUTCOME
MEASURE--Percentage of patients referred for coronary angiography or
revascularization for appropriate, uncertain, or inappropriate indications.
RESULTS--Of the patients referred for angiography, 89% were classified as
appropriate, 9% as uncertain, and 2% as inappropriate. The percentages are
similar for patients referred for coronary artery bypass graft surgery and
for angioplasty (91% and 86%, respectively, classified as appropriate). The
majority of patients had chest pain rated as Canadian Cardiovascular
Society classes II through IV (93%), despite maximum anti-ischemic therapy
in 90% of these patients. CONCLUSIONS--Few patients were referred for
coronary angiography or revascularization for inappropriate or uncertain
indications. The percentage of these patients who are from southwestern
Sweden is similar to the percentage recently reported from New York State.
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Int J Qual Health Care 2005;17:315-321.
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Assessment of Indications in Interventional Cardiology: Appropriateness and Necessity of Coronary Angiography and Revascularization
Schilling et al.
American Journal of Medical Quality 2003;18:155-163.
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Hypothetical ratings of coronary angiography appropriateness: are they associated with actual angiographic findings, mortality, and revascularisation rate? The ACRE study
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Hemingway et al.
NEJM 2001;344:645-654.
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ACC/AHA guidelines for coronary angiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in collaboration with the Society for Cardiac Angiography and Interventions
Scanlon et al.
J Am Coll Cardiol 1999;33:1756-1824.
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Bernstein et al.
Heart 1999;81:470-477.
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The Reproducibility of a Method to Identify the Overuse and Underuse of Medical Procedures
Shekelle et al.
NEJM 1998;338:1888-1895.
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Selby et al.
NEJM 1996;335:1888-1896.
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