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Doctor 'report cards' may keep some heart patients from getting angioplasties

ANN ARBOR, Mich. -- No one likes to have a bad mark on a report card. But a new study suggests that heart doctors who are publicly "graded" on their angioplasty results may be shying away from performing the procedure on the high-risk patients who are most likely to drag down their averages.

The study is the first ever to compare data from a state that requires public reporting of angioplasty results -- New York -- with data from a state without public reporting -- Michigan. It reveals some striking differences, though it can't show a direct cause-and-effect relationship between public reporting and doctors' selection of patients.

The study, which is being published in the June 7 issue of the Journal of the American College of Cardiology, was performed by University of Michigan Cardiovascular Center researchers in collaboration with researchers from the State University of New York at Stony Brook.

Overall, the New York patients who received angioplasties to open clogged heart arteries were far less likely than Michigan patients to have underlying or acute conditions that raised their risk of dying before they left the hospital. And Michigan angioplasty patients were twice as likely as New York patients to die in the hospital.

But when the researchers corrected for the fact that Michigan patients were much sicker on average than the New York patients before their angioplasties, they found that there was no difference in overall death risk between the two states. Because the states have similar heart disease patterns, the team concluded that the difference in patient selection might be due to the presence of public reporting in New York.

The study team was led by Mauro Moscucci, M.D., FACC, who directs interventional cardiology at U-M and for nearly a decade has led an angioplasty quality-improvement project funded by Blue Cross Blue Shield of Michigan.

The grant and data from that project, called the BCBSM Cardiovascu
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
6-Jun-2005


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