Malpractice damage caps associated with change in CAD testing, Tx

June 8, 2018

(HealthDay)—Following adoption of damage caps, physicians alter their approach to coronary artery disease testing and follow-up after initial ischemic evaluations, according to a study published online June 6 in JAMA Cardiology.

Steven A. Farmer, M.D., Ph.D., from George Washington University in Washington, D.C., and colleagues examined whether reducing malpractice risk is associated with clinical decisions involving testing and treatment. Physician-specific changes in coronary artery disease testing and treatment were compared in nine new-cap states that adopted damage caps between 2003 and 2005 and 20 states without caps. Data were included for 36,647 physicians in new-cap states and 39,154 physicians in no-cap states.

The researchers observed a reduction in invasive testing as a first diagnostic among new-cap physicians after cap adoption compared with control physicians (relative change, −24 percent), with an offsetting non-significant increase in non-invasive stress testing (7.8 percent); in addition, fewer patients were referred for angiography after stress testing (−21 percent). Reduced revascularization rates were seen after ischemic evaluation among new-cap physicians (−23 percent), driven by fewer percutaneous coronary interventions. Similar changes in overall ischemic evaluation rates were seen for new-cap and control physicians.

"These findings suggest that physicians tolerate greater clinical uncertainty in coronary artery testing and treatment if they face lower malpractice risk," the authors write.

Explore further: AHA: noninvasive testing ups LOS in patients with chest pain

More information: Abstract/Full Text

Related Stories

AHA: noninvasive testing ups LOS in patients with chest pain

November 15, 2017
(HealthDay)—Noninvasive cardiac testing leads to longer length of stay (LOS) for patients presenting to the emergency department with chest pain, according to a study published online Nov. 14 in JAMA Internal Medicine to ...

MI incidence down with CT angiography in suspected CAD

October 4, 2017
(HealthDay)—For patients with suspected coronary artery disease (CAD), coronary computed tomography angiography (CCTA) is associated with reduced incidence of myocardial infarction but no reduction in death or cardiac hospitalization ...

Women and men should receive similar treatment decisions for heart disease, study argues

March 9, 2018
Women have conventionally been considered a risk factor for coronary artery bypass grafting (CABG), a type of open-heart surgery that improves blood flow to the heart. But a research paper by an international team of researchers, ...

CT angiography appears better at predicting future risk for patients with chest pain

June 13, 2017
An analysis of diagnostic test results from the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial - in which patients with stable chest pain were randomized to either anatomic or functional ...

Percutaneous coronary intervention is a well-justified option in severe coronary artery disease

December 12, 2017
The treatment of left main coronary artery disease by percutaneous coronary intervention is associated with a smaller risk of severe cardiovascular events than coronary artery bypass grafting in the weeks following surgery. ...

Physician, system factors affect CAD detection rates

September 11, 2014
(HealthDay)—Nonclinical factors account for considerable variation in the detection of obstructive coronary artery disease (CAD) with coronary angiogram, according to a study published online Sept. 2 in Circulation: Cardiovascular ...

Recommended for you

New cellular pathway helps explain how inflammation leads to artery disease

June 21, 2018
Investigators have identified a new cellular pathway that may help explain how arterial inflammation develops into atherosclerosis—deposits of cholesterol, fats and other substances that create plaque, clog arteries and ...

'Smart stent' detects narrowing of arteries

June 19, 2018
For every three individuals who have had a stent implanted to keep clogged arteries open and prevent a heart attack, at least one will experience restenosis—the renewed narrowing of the artery due to plaque buildup or scarring—which ...

Marriage may protect against heart disease / stroke and associated risk of death

June 18, 2018
Marriage may protect against the development of heart disease/stroke as well as influencing who is more likely to die of it, suggests a pooled analysis of the available data, published online in the journal Heart.

Deaths from cardiac arrest are misclassified, overestimated

June 18, 2018
Forty percent of deaths attributed to cardiac arrest are not sudden or unexpected, and nearly half of the remainder are not arrhythmic—the only situation in which CPR and defibrillators are effective—according to an analysis ...

Tick-borne meat sensitivity linked to heart disease

June 15, 2018
University of Virginia School of Medicine researchers have linked sensitivity to an allergen in red meat—a sensitivity spread by tick bites—with a buildup of fatty plaque in the arteries of the heart. This buildup may ...

The molecules that energize babies' hearts

June 14, 2018
A metabolic process that provides heart muscle with energy fails to mature in newborns with thickened heart walls, according to a Japan–Canada research team.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.