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Research Letter
December 2015

Patterns of Institutional Review of Percutaneous Coronary Intervention Appropriateness and the Effect on Quality of Care and Clinical Outcomes

Author Affiliations
  • 1Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut
  • 2Center for Outcomes Research and Evaluation, Yale–New Haven Health Services Corporation, New Haven, Connecticut
  • 3Division of Cardiology, University of Colorado School of Medicine, Aurora
  • 4Division of Cardiovascular Diseases, University of Michigan, Ann Arbor
  • 5Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Intern Med. 2015;175(12):1988-1990. doi:10.1001/jamainternmed.2015.6217

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.

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