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Michael S. Lauer, MD

JAMA. 2000;283:2988-2989.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Twelve years ago, Ellwood¹ described "a technology of experience" by which observational databases would be used to learn about how best to improve implementation of medical interventions. Ellwood envisioned a unified national database containing information on all facets of patient care. Researchers and decision makers would have the ability to analyze relevant data to answer questions of interest. Although a single national database of this kind has not been realized, a number of very large registries have been successfully assembled and used to learn about important associations between treatments and outcomes.² In this issue of THE JOURNAL, Cannon et al³ report on the relation between speed of performing primary angioplasty and in-hospital mortality among patients with acute myocardial infarction. Taking advantage of a multicenter database containing information about more than 750,000 patients, the authors focused on 27,080 patients who presented with ST-segment elevation or left bundle-branch . . . [Full Text of this Article]

Author Affiliation: Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio.

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