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Use of Diagnostic Tests and Therapeutic Procedures in a Changing Health Care Environment
Arnold M. Epstein, MD, MA
JAMA. 1996;275(15):1197-1198.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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Two articles in this week's issue of THE JOURNAL, both based on large-scale administrative data, examine the links between use of diagnostic tests and subsequent use of related surgical procedures. Wennberg et al1 examined data from small areas in New England and showed that use of imaging stress electrocardiograms is closely related to subsequent use of angiography and use of stress electrocardiograms and angiography is strongly related to subsequent use of revascularization. Verilli and Welch2 used national Medicare claims data to show similar linkage for five diagnostic-therapeutic pairs: cardiac catheterization with cardiac revascularization, imaging of the spine with back surgery, swallowing studies with percutaneous gastroscopy, mammography with breast biopsy/excision, and prostate biopsy with prostatectomy. Together these two articles provide convincing evidence that increased use of a range of therapeutic procedures is strongly associated with prior use of related diagnostic tests.
See also pp 1161 and 1189.
The association
. . . [Full Text PDF of this Article]
Author Affiliations
From the Division of General Medicine, Section on Health Services and Policy Research, Department of Medicine, Brigham and Women's Hospital; Department of Health Care Policy, Harvard Medical School; and Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass.
Footnotes
Reprints: Arnold M. Epstein, MD, MA, Department of Health Care Policy, Harvard Medical School, 25 Shattuck St, Parcel B, Boston, MA 02115.
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