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Titolo:
Assessing the appropriateness of coronary revascularization: The University of Maryland Revascularization Appropriateness Score (RAS) and its comparison to RAND Expert Panel Ratings and American College of Cardiology American Heart Association guidelines with regard to assigned appropriateness rating and ability to predict outcome
Autore:
Ziskind, AA; Lauer, MA; Bishop, G; Vogel, RA;
Indirizzi:
Univ Maryland, Dept Med, Div Cardiol, Baltimore, MD 21201 USA Univ Maryland Baltimore MD USA 21201 Div Cardiol, Baltimore, MD 21201 USA Cleveland Clin Fdn, Dept Cardiol, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 ardiol, Cleveland, OH 44195 USA
Titolo Testata:
CLINICAL CARDIOLOGY
fascicolo: 2, volume: 22, anno: 1999,
pagine: 67 - 76
SICI:
0160-9289(199902)22:2<67:ATAOCR>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; CARDIOVASCULAR PROCEDURES COMMITTEE; BYPASS GRAFT-SURGERY; ACC AHA GUIDELINES; NEW-YORK-STATE; TASK-FORCE; PROCEDURES SUBCOMMITTEE; CARDIOGENIC-SHOCK; 2ND RESTENOSIS; ARTERY SURGERY;
Keywords:
revascularization appropriateness; guidelines; coronary artery disease;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: Ziskind, AA UnivMDaryland, Dept Med, Div Cardiol, 250 W Pratt St,Suite 880, Baltimore, Univ Maryland 250 W Pratt St,Suite 880 Baltimore MD USA 21201
Citazione:
A.A. Ziskind et al., "Assessing the appropriateness of coronary revascularization: The University of Maryland Revascularization Appropriateness Score (RAS) and its comparison to RAND Expert Panel Ratings and American College of Cardiology American Heart Association guidelines with regard to assigned appropriateness rating and ability to predict outcome", CLIN CARD, 22(2), 1999, pp. 67-76

Abstract

Background: Significant regional variation in procedural frequencies has led to the development of the RAND and American College of Cardiology/American Heart Association (ACC/AHA) guidelines; however, they may be difficult to apply in clinical practice. The University of Maryland Revascularization Appropriateness Score (RAS) was created to address the need for a simplified point scoring system. Hypothesis: The study was undertaken to compare revascularization appropriateness ratings yielded by the RAND Expert Panel Ratings, ACC/AHA guidelines, and the University of Maryland RAS. Methods: We applied these three revascularization appropriateness scoring systems to 153 catheterization laboratory patients with a variety of cardiac diagnoses and treatments. For each patient, appropriateness scores assigned by each of the three systems were compared with each other and with the actual treatment delivered. Concordance of care with appropriateness score was then correlated with outcome. Results: There were significant differences among all three scoring systems in their ratings and in the concordance of treatment with appropriatenessrating. When treatment provided was concordant with RAND rating, there wasa lower occurrence of subsequent coronary artery bypass grafting (CABG), the composite end point of either CABG or percutaneous transluminal coronaryangioplasty (PTCA), and the composite end point of death, myocardial infarction (MI), or revascularization. When treatment was concordant with the ACC/AHA guidelines, there was lower occurrence of all-cause mortality, PTCA, the composite end point of either CABG or PTCA, and the composite end pointof death, MI, or revascularization. When treatment provided was concordantwith the RAS, there was lower occurrence of cardiac death, all-cause death, CABG, the composite end point of either CABG or PTCA, and the composite end point of death, MI, or revascularization. Conclusions: The RAS is a simple scoring system to assess revascularization appropriateness. When the RAND, ACC/AHA, and RAS systems are compared in a catheterization laboratory population, they rate the same patient differently and vary in their correlation of appropriateness rating with outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/05/20 alle ore 12:44:35