Local Practice Patterns Drive Diagnostic Angios
There is wide variation among U.S. institutions in the rate of positive findings of obstructive coronary artery disease (CAD) when patients undergo diagnostic angiography, a retrospective study found.
Among hospitals, the rate of positive findings (≥50% obstruction) varied from 23% to 100%, reported Pamela S. Douglas, MD, from Duke University Medical Center in Durham, N.C., and colleagues.
Hospitals with lower rates of obstructive CAD findings performed coronary angiography more often in younger patients, women, blacks, and outpatients (all P <0.0001.
Even when researchers changed the definition of CAD (≥70% or >20%), the rates of finding obstructive CAD remained consistent overall and among individual institutions.
The investigators admitted that their use of the NCDR CathPCI data base did not allow them to determine whether the choice of diagnostic angiography was appropriate or not. Nor do they have data regarding long-term clinical outcomes.
In fact, a statement from the Society for Cardiovascular Angiography and Interventions (SCAI) cautioned against using these findings to "evaluate quality of care provided by a specific medical center."
"Currently, there are no standards for the optimal percent of positive diagnostic coronary angiography tests, and it is natural for there to be some variation in rates among hospitals," according to the statement.
SCAI noted several reasons that variation among centers might occur: Some cath labs may be better equipped to care for high-risk patients, while others are able to diagnose patients, but may not treat high-risk patients, resulting in variation between diagnostic procedures performed and subsequent treatments. Centers performing more diagnostic procedures were more likely to treat young, African American, or female patients. These are patient groups that tend to be at higher risk but whose symptoms are often masked or atypical, so physicians may need to perform diagnostic angiography to rule out CAD. Three-quarters of patients in the study had abnormal noninvasive tests (such as nuclear and stress echo tests), indicating possible CAD. Results from the present study may reflect variation in the interpretation of noninvasive tests, rather than variation in use of diagnostic angiography. Frequency of diagnostic procedures of all types can also be impacted by patient and family expectations and legal concerns.
"The question the interventional cardiology community is working to answer is, 'How do we help hospitals and individual physicians balance the important need to discover and treat patients with potentially life-threatening illness with the need to protect others who may not have CAD from the risks of additional testing?'," said Christopher J. White, MD, SCAI president and chairman of the department of cardiology at the Ochsner Heart & Vascular Institute in New Orleans, in the statement.
Spearman Rank Correlation - News
Individually, hospital rates remained stable over time, with high correlation in year-to-year individual hospital performance: (Spearman's rank correlation) rho=0.72 (2005 versus 2006) and rho=0.73 (2006 versus 2007), both P<0.0001.
Our calculations suggest there isn't enough proof that capital punishment is or isn't an effective deterrent to murder. *El Salvador impose the penalty only in exceptional cases. **Correlation derived using Spearman's Rank Correlation Coefficient using
Spearman rank correlation was used to assess the relationship between thalamic RSNs and performance on neuropsychological and neurobehavioral measures in patients. The investigators found that healthy subjects had a normal pattern of thalamic RSNs,
Significant impact on survival was determined using log-rank tests. Significant variables were integrated into a Cox regression model and a new variable called integrative score of individual risk (ISIR), based on Spearman's correlations, was obtained.
Eagle Feather » HIV/AIDS Morbidity in Youths and Teens Ages 13-24 ...
Bio: Meagan Hatton is currently a junior double majoring in Geography and Photojournalism at the University of North Texas. She has been on the Dean’s List numerous times and is a member of the Tau Sigma Honor Society as well. She is a proud member of the North Texas Energy and Environment Club and was the Event Coordinator for the club in 2010-2011 and is currently the President for 2011-2012. Meagan is also a member of the Sustainability Council on campus and works with the Operations and Land Use Sub-committee, which is responsible for making recommendations about the physical campus environment and how to sustainably maintain the built environment as well as the Recycling Committee for campus. Meagan is also a campus leader for Re-Energize Texas, an organization devoted to changing Texas’s energy future. Among other things, Meagan is also a member of NORML, a dancer for UNT’s African Ensemble, and works 20+ hours a week. She plans to volunteer for the Peace Corps after graduation in hopes of helping children in Africa who are living with HIV/AIDS. She wishes to pursue a career in Medical Geography working in Africa and dreams of being a photographer for National Geographic. After working for several years, Meagan plans to return to school to get a Master’s degree in Medical Geography and Sustainability. Meagan’s overall goal in life, she says, is to “provide positivity while helping others and using education as a tool to get there.” Abstract: HIV/AIDS has become a serious threat in Texas among youths and teens, and will continue to grow as a problem unless action is taken to prevent the spread of the virus. From 2002-2008, the HIV rate among youths and teens, ages 13-24, increased 38%, from 14.2 per 100,000 to 19.6 per 100,000 (Texas Department of State Health Services, 2010). Using case data provided by the Texas State Department of Health Services, this paper seeks to understand the spatial distribution of HIV/AIDS morbidity among youths and teens ages 13-24 and the variables that are significantly related to the disease. De-identified data on HIV/AIDS for Texas counties from 1999-2008 provided by the Texas State Department of Health are used as the dependent variable. Explanatory variables for this research include: race/ethnicity, level of education, percent urban population, socioeconomic factors, and prevalence of unsafe sex, which is provided by the 2000 U.S.
Spearman Rank Correlation - Bookshelf
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A Spearman correlation of 1 results when the two variables being compared are ... In statistics, Spearman's rank correlation coefficient or Spearman's rho, named ...
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Spearman's rank correlation
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Spearman's rank correlation coefficient ( ¦spirmənz ¦raŋk ′kärə′lāshən ′kōə′fishənt ) ( statistics ) A statistic used as a measure of
Spearman\'s rank correlation coefficient - Citizendia
In statistics, Spearman's rank correlation coefficient or Spearman's rho, named after Charles Spearman and often denoted by the Greek letter ρ ...