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February 22/29, 2012

Physician Billing and Cardiac Stress Testing Patterns—Reply

Author Affiliations

Author Affiliations: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina (bimal.shah@duke.edu).

JAMA. 2012;307(8):781-783. doi:10.1001/jama.2012.190

In Reply: Dr Pellikka and colleagues raise the concern that our study does not adequately test the American College of Cardiology Foundation's AUC.1-3 We generally agree, but this was not our goal. Our objective was to assess differences in use by billing status for an indication that is common in clinical practice. We hope that in the future physician decision support tools may help guide physicians in identifying patients who meet AUC for cardiovascular testing and thereby reduce variation in testing patterns.