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More than 600 000 percutaneous coronary interventions (PCIs) are performed each year, accounting for more than $12 billion in health care spending.1 In 2009, the American College of Cardiology, American Heart Association, and several other professional organizations released appropriate use criteria (AUC) for coronary revascularization2 designed to support better selection of patients for PCI. Prior studies1,3,4 suggest that as many as 1 in 6 nonacute PCIs may be inappropriate (rarely appropriate). Although the AUC have received substantial attention, little is known about how institutions have responded to them, specifically whether they have developed mechanisms for internal review of PCI appropriateness. Furthermore, whether these review practices are associated with differences in procedural appropriateness, quality of care, and patient outcomes remains uncertain.
Desai NR, Parzynski CS, Krumholz HM, Minges KE, Messenger JC, Nallamothu BK, Curtis JP. Patterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes. JAMA Intern Med. 2015;175(12):1988-1990. doi:10.1001/jamainternmed.2015.6217