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Variation in additional testing and patient outcomes after stress echocardiography or myocardial perfusion imaging, according to accreditation status of testing site

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The purpose of the present study was to determine whether patients receiving a stress echocardiogram or myocardial perfusion imaging (MPI) test have differences in subsequent testing and outcomes according to accreditation status of the original testing facility.

Methods and results

An all-payer claims dataset from Maine Health Data Organization from 2012 to 2014 was utilized to define two cohorts defined by an initial stress echocardiogram or MPI test. The accreditation status (Intersocietal Accreditation Commission (IAC), American College of Radiology (ACR) or none) of the facility performing the index test was known. Descriptive statistics and multivariate regression were used to examine differences in subsequent diagnostic testing and cardiac outcomes.

We observed 4603 index stress echocardiograms and 8449 MPI tests. Multivariate models showed higher odds of subsequent MPI testing and hospitalization for angina if the index test was performed at a non-accredited facility in both the stress echocardiogram cohort and the MPI cohort. We also observed higher odds of percutaneous coronary interventions (PCI) performed (OR 1.68, 95% CI 1.13-2.50), if the initial MPI test was done in a non-accredited facility.

Conclusion

Cardiac testing completed in non-accredited facilities were associated with higher odds of subsequent MPI testing, hospitalization for angina, and PCI.

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Abbreviations

MPI:

Myocardial perfusion imaging

IAC:

Intersocietal Accreditation Commission

ACR:

American College of Radiology

CAD:

Coronary artery disease

CABG:

Coronary artery bypass grafting

PCI:

Percutaneous coronary interventions

AMI:

Acute myocardial infarction

CPT:

Current Procedural Terminology

ICD:

International Classification of Diseases

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Disclosure

Dr. Mylan Cohen serves on the IAC Board of Directors, as the President of the IAC Nuclear/Positron emission tomography Board of Directors, and as a Secretary of the IAC. He has also served as a past president of American Society of Nuclear Cardiology and he is on the editorial board of the Journal of Nuclear Cardiology.

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Authors and Affiliations

  1. Maine Medical Center, 22 Bramhall St, Portland, ME, 04103, UK

    Jay N. Shah MD

  2. Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, UK

    Kimberly M. Murray MPP, F. L. Lucas PhD, Kathleen M. Fairfield MD, MPH, DrPH & Mylan C. Cohen MD, MPH

  3. Maine Medical Partners MaineHealth Cardiology, Portland, UK

    Mylan C. Cohen MD, MPH

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  1. Jay N. Shah MD
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Correspondence to Jay N. Shah MD.

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Funding

This research was funded by the Intersocietal Accreditation Commission (IAC). They also provided data on accreditation sites from the appropriate time period.

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Shah, J.N., Murray, K.M., Lucas, F.L. et al. Variation in additional testing and patient outcomes after stress echocardiography or myocardial perfusion imaging, according to accreditation status of testing site. J. Nucl. Cardiol. 28, 2952–2961 (2021). https://doi.org/10.1007/s12350-020-02230-0

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