Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes
Safavi KC, Li SX, Dharmarajan K, Venkatesh AK, Strait KM, Lin H, Lowe TJ, Fazel R, Nallamothu BK, Krumholz HM. Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes. JAMA Internal Medicine 2014, 174: 546-553. PMID: 24515551, PMCID: PMC5459406, DOI: 10.1001/jamainternmed.2013.14407.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoninvasive cardiac imagingDownstream testingReadmission ratesRevascularization proceduresCardiac imagingHospital variationCardiac ischemiaProportion of patientsNoninvasive imagingLower readmission ratesPrincipal discharge diagnosisCross-sectional studyCardiac biomarker testsQ4 hospitalsChest discomfortCoronary angiographyCoronary diseaseDischarge diagnosisCoronary angiogramEmergency departmentMyocardial infarctionSame hospitalCurrent guidelinesInpatient wardsHospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure
Kulkarni VT, Kim N, Dai Y, Dharmarajan K, Safavi KC, Bikdeli B, Lindenauer PK, Testani J, Dries DL, Krumholz HM. Hospital Variation in Noninvasive Positive Pressure Ventilation for Acute Decompensated Heart Failure. Circulation Heart Failure 2014, 7: 427-433. PMID: 24633829, PMCID: PMC4386575, DOI: 10.1161/circheartfailure.113.000698.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNoninvasive positive pressure ventilationDecompensated heart failureRisk-standardized mortality ratesPositive pressure ventilationHeart failureIntubation rateMortality ratePressure ventilationUse of NPPVHospital risk-standardized mortality ratesHigher intubation rateHospital practice patternsHospital-level outcomesCross-sectional studyHierarchical logistic regression modelsLogistic regression modelsNIPPV useHospital variationSuch hospitalizationsPractice patternsHospitalizationHospitalQuartileBottom quartile