Physician decision making and trends in the use of cardiac stress testing in the United States: An analysis of repeated cross-sectional data

Annals of Internal Medicine

Volumn 161, Issue 7, 2014, Pages 482-490

  Ladapo, Joseph A ^a   Blecker, Saul ^a   Douglas, Pamela S ^b  

^a NEW YORK UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b DUKE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; CARDIAC IMAGING; CARDIAC STRESS TEST; CARDIOVASCULAR RISK; CARDIOVASCULAR SYSTEM EXAMINATION; CLINICAL DECISION MAKING; CONTROLLED STUDY; CROSS-SECTIONAL STUDY; DEMOGRAPHY; ETHNICITY; FEMALE; HEALTH CARE COST; HEALTH CARE SURVEY; HISPANIC; HUMAN; ISCHEMIC HEART DISEASE; MAJOR CLINICAL STUDY; MALE; MEDICAL CARE; NEOPLASM; PATIENT REFERRAL; PHYSICIAN; RACE; UNITED STATES; ADOLESCENT; CLINICAL PRACTICE; CORONARY DISEASE; DECISION MAKING; ETHNIC GROUP; EXERCISE TEST; MIDDLE AGED; RISK FACTOR; TRENDS; UTILIZATION; VERY ELDERLY; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; CARDIAC IMAGING TECHNIQUES; CORONARY DISEASE; CROSS-SECTIONAL STUDIES; DECISION MAKING; DEMOGRAPHY; ETHNIC GROUPS; EXERCISE TEST; HEALTH CARE SURVEYS; HUMANS; MIDDLE AGED; PHYSICIAN'S PRACTICE PATTERNS; RISK FACTORS; UNITED STATES; YOUNG ADULT;

EID: 84908110449     PISSN: 00034819     EISSN: 15393704     Source Type: Journal    
DOI: 10.7326/M14-0296     Document Type: Article

References (45)

1. Shaw LJ, Marwick TH, Zoghbi WA, Hundley WG, Kramer CM, Achenbach S, et al. Why all the focus on cardiac imaging? [Editorial]. JACC Cardiovasc Imaging. 2010;3:789-94. [PMID: 20633864] doi:10.1016/j.jcmg.2010.05.004
2. Gibbons RJ, Miller TD, Hodge D, Urban L, Araoz PA, Pellikka P, et al. Application of appropriateness criteria to stress single-photon emission computed tomography sestamibi studies and stress echocardiograms in an academic medical center. J Am Coll Cardiol. 2008;51:1283-9. [PMID: 18371560] doi:10.1016 /j.jacc.2007.10.064
3. Brenner DJ. Medical imaging in the 21st century-getting the best bang for the rad [Editorial]. N Engl J Med. 2010;362:943-5. [PMID: 20220190] doi: 10.1056/NEJMe1000802
4. Levin DC, Rao VM, Parker L, Frangos AJ, Sunshine JH. Bending the curve: the recent marked slowdown in growth of noninvasive diagnostic imaging. AJR Am J Roentgenol. 2011;196:W25-9. [PMID: 21178027] doi:10.2214 /AJR.10.4835
5. Iglehart JK. Health insurers and medical-imaging policy-a work in progress. N Engl J Med. 2009;360:1030-7. [PMID: 19264694] doi:10.1056 /NEJMhpr0808703
6. American College of Cardiology, ABIM Foundation. Choosing Wisely: imaging tests for heart disease: when you need them-and when you don't. Philadelphia: ABIM Foundation; 2013. Accessed at www.choosingwisely.org/doctor-patient-lists/imaging-tests-for-heart-disease on 8 July 2013.
7. Cassel CK, Guest JA. Choosing wisely: helping physicians and patients make smart decisions about their care. JAMA. 2012;307:1801-2. [PMID: 22492759] doi:10.1001/jama.2012.476
8. Rao VM, Levin DC. The overuse of diagnostic imaging and the Choosing Wisely initiative. Ann Intern Med. 2012;157:574-6. [PMID: 22928172]
9. American Society of Nuclear Cardiology, ABIM Foundation. Choosing Wisely: stress tests for chest pain: when you need an imaging test-and when you don't. Philadelphia: ABIM Foundation; 2012. Accessed at www.choosingwisely.org/doctor-patient-lists/stress-tests-for-chest-pain on 8 July 2013.
10. American Academy of Family Physicians, ABIM Foundation. Choosing Wisely: EKGs and exercise stress tests: when you need them for heart disease- and when you don't. Philadelphia: ABIM Foundation; 2012. Accessed at www.choosingwisely.org/doctor-patient-lists/ekgs-and-exercise-stress-tests on 8 July 2013.
11. American College of Physicians, ABIM Foundation. Choosing Wisely: Stress tests for chest pain: When you need an imaging test-and when you don't. Philadelphia: ABIM Foundation; 2012. Accessed at http://www.choosingwisely.org/doctor-patient-lists/stress-tests-for-chest-pain/ on 8 July 2013.
12. Will JC, Loustalot F, Hong Y. National trends in visits to physician offices and outpatient clinics for angina 1995 to 2010. Circ Cardiovasc Qual Outcomes. 2014;7:110-7. [PMID: 24425707] doi:10.1161/CIRCOUTCOMES .113.000450
13. Lucas FL, DeLorenzo MA, Siewers AE, Wennberg DE. Temporal trends in the utilization of diagnostic testing and treatments for cardiovascular disease in the United States, 1993-2001. Circulation. 2006;113:374-9. [PMID: 16432068]
14. Andrus BW, Welch HG. Medicare services provided by cardiologists in the United States: 1999-2008. Circ Cardiovasc Qual Outcomes. 2012;5:31-6. [PMID: 22235064] doi:10.1161/CIRCOUTCOMES.111.961813
15. Rozanski A, Gransar H, Hayes SW, Min J, Friedman JD, Thomson LE, et al. Temporal trends in the frequency of inducible myocardial ischemia during cardiac stress testing: 1991 to 2009. J Am Coll Cardiol. 2013;61:1054-65. [PMID: 23473411] doi:10.1016/j.jacc.2012.11.056
16. Shaw LJ, Miller DD, Romeis JC, Kargl D, Younis LT, Chaitman BR. Gender differences in the noninvasive evaluation and management of patients with suspected coronary artery disease. Ann Intern Med. 1994;120:559-66. [PMID: 8116993]
17. Miller TD, Roger VL, Hodge DO, Hopfenspirger MR, Bailey KR, Gibbons RJ. Gender differences and temporal trends in clinical characteristics, stress test results and use of invasive procedures in patients undergoing evaluation for coronary artery disease. J Am Coll Cardiol. 2001;38:690-7. [PMID: 11527619]
18. Roger VL, Jacobsen SJ, Pellikka PA, Miller TD, Bailey KR, Gersh BJ. Gender differences in use of stress testing and coronary heart disease mortality: a population-based study in Olmsted County, Minnesota. J Am Coll Cardiol. 1998;32:345-52. [PMID: 9708459]
19. Chang AM, Mumma B, Sease KL, Robey JL, Shofer FS, Hollander JE. Gender bias in cardiovascular testing persists after adjustment for presenting characteristics and cardiac risk. Acad Emerg Med. 2007;14:599-605. [PMID: 17538080]
20. Cohen MC, Stafford RS, Misra B. Stress testing: national patterns and predictors of test ordering. Am Heart J. 1999;138:1019-24. [PMID: 10577430]
21. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2013 update: a report from the American Heart Association. Circulation. 2013;127:e6-e245. [PMID: 23239837] doi:10.1161/CIR.0b013e31828124ad
22. Feinstein M, Ning H, Kang J, Bertoni A, Carnethon M, Lloyd-Jones DM. Racial differences in risks for first cardiovascular events and noncardiovascular death: the Atherosclerosis Risk in Communities study, the Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis. Circulation. 2012;126: 50-9. [PMID: 22693351] doi:10.1161/CIRCULATIONAHA.111.057232
23. National Center for Health Statistics. Ambulatory health care data: questionnaires, datasets, and related documention: survey methodology. Atlanta, GA: Centers for Disease Control and Prevention; 2013. Accessed at www.cdc.gov/nchs/ahcd/ahcd-questionnaires.htm on 4 June 2013.
24. National Center for Health Statistics. 2009 NAMCS public-use data file documentation. Atlanta, GA: Centers for Disease Control and Prevention; 2009. Accessed at ftp://ftp.cdc.gov/pub/health-statistics/NCHS/Dataset-Documentation/NAMCS/doc09.pdf on 4 June 2013.
25. Wolk MJ, Bailey SR, Doherty JU, Douglas PS, Hendel RC, Kramer CM, et al; American College of Cardiology Foundation Appropriate Use Criteria Task Force. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;63:380-406. [PMID: 24355759] doi:10.1016/j.jacc.2013.11.009
26. Hsiao WC, Braun P, Dunn D, Becker ER. Resource-based relative values. An overview. JAMA. 1988;260:2347-53. [PMID: 3050169]
27. Shreibati JB, Baker LC, Hlatky MA. Association of coronary CT angiography or stress testing with subsequent utilization and spending among Medicare beneficiaries. JAMA. 2011;306:2128-36. [PMID: 22089720] doi:10.1001/jama.2011.1652
28. Berrington de Gonzalez A, Kim KP, Smith-Bindman R, McAreavey D. Myocardial perfusion scans: projected population cancer risks from current levels of use in the United States. Circulation. 2010;122:2403-10. [PMID: 21098448] doi:10.1161/CIRCULATIONAHA.110.941625
29. Einstein AJ, Weiner SD, Bernheim A, Kulon M, Bokhari S, Johnson LL, et al. Multiple testing, cumulative radiation dose, and clinical indications in patients undergoing myocardial perfusion imaging. JAMA. 2010;304:2137-44. [PMID: 21078807] doi:10.1001/jama.2010.1664
30. National Center for Health Statistics. Ambulatory health care data: reliability of estimates. Atlanta, GA: Centers for Disease Control and Prevention; 2013. Accessed at www.cdc.gov/nchs/ahcd/ahcd-estimation-reliability.htm on 4 June 2013.
31. Ladapo JA, Hoffmann U, Bamberg F, Nagurney JT, Cutler DM, Weinstein MC, et al. Cost-effectiveness of coronary MDCT in the triage of patients with acute chest pain. AJR Am J Roentgenol. 2008;191:455-63. [PMID: 18647917] doi:10.2214/AJR.07.3611
32. Ladapo JA, Jaffer FA, Hoffmann U, Thomson CC, Bamberg F, Dec W, et al. Clinical outcomes and cost-effectiveness of coronary computed tomography angiography in the evaluation of patients with chest pain. J Am Coll Cardiol. 2009;54:2409-22. [PMID: 20082932] doi:10.1016/j.jacc.2009.10.012
33. Ladapo JA, Blecker S, Elashoff MR, Federspiel JJ, Vieira DL, Sharma G, et al. Clinical implications of referral bias in the diagnostic performance of exercise testing for coronary artery disease. J Am Heart Assoc. 2013;2:e000505. [PMID: 24334965] doi:10.1161/JAHA.113.000505
34. Brindis RG, Douglas PS, Hendel RC, Peterson ED, Wolk MJ, Allen JM, et al; American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group. ACCF/ASNC appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI): a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association. J Am Coll Cardiol. 2005;46:1587-605. [PMID: 16226194]
35. Lauer MS, Pashkow FJ, Snader CE, Harvey SA, Thomas JD, Marwick TH. Gender and referral for coronary angiography after treadmill thallium testing. Am J Cardiol. 1996;78:278-83. [PMID: 8759804]
36. Shaw LJ, Vasey C, Sawada S, Rimmerman C, Marwick TH. Impact of gender on risk stratification by exercise and dobutamine stress echocardiography: long-term mortality in 4234 women and 6898 men. Eur Heart J. 2005;26:447-56. [PMID: 15687253]
37. The Myocardial Perfusion Imaging Market Guide (U.S.): Supplement to the U.S. Imaging Market Guide. Malvern, PA: Arlington Medical Resources; 2007.
38. The Echocardiography Market Guide (U.S.): Supplement to the U.S. Imaging Market Guide. Malvern, PA: Arlington Medical Resources; 2009.
39. ACR Appropriateness Criteria. Reston, VA: American Coll of Radiology; 2014. Accessed at www.acr.org/Quality-Safety/Appropriateness-Criteria on 28 January 2014.
40. Centers for Disease Control and Prevention. Healthy People: Healthy People 2010. Atlanta, GA: Centers for Disease Control and Prevention; 2014. Accessed at www.cdc.gov/nchs/healthy-people/hp2010.htm on 10 July 2013.
41. Nelson K, Norris K, Mangione CM. Disparities in the diagnosis and pharmacologic treatment of high serum cholesterol by race and ethnicity: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2002;162:929-35. [PMID: 11966345]
42. Goff DC Jr, Bertoni AG, Kramer H, Bonds D, Blumenthal RS, Tsai MY, et al. Dyslipidemia prevalence, treatment, and control in the Multi-Ethnic Study of Atherosclerosis (MESA): gender, ethnicity, and coronary artery calcium. Circulation. 2006;113:647-56. [PMID: 16461837]
43. McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: U.S. trends from 1999 to 2006 and effects of medicare coverage. Ann Intern Med. 2009;150:505-15. [PMID: 19380852]
44. Lillie-Blanton M, Maddox TM, Rushing O, Mensah GA. Disparities in cardiac care: rising to the challenge of Healthy People 2010. J Am Coll Cardiol. 2004;44:503-8. [PMID: 15358011]
45. Bradley EH, Herrin J, Wang Y, McNamara RL, Webster TR, Magid DJ, et al. Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction. JAMA. 2004;292:1563-72. [PMID: 15467058]