Loading…
Appropriateness Ratings of Percutaneous Coronary Intervention in Japan and Its Association With the Trend of Noninvasive Testing
Abstract Objectives The aim of this study was to evaluate the appropriateness of percutaneous coronary intervention (PCI) in Japan and clarify the association between trends of pre-procedural noninvasive testing and changes in appropriateness ratings. Background Although PCI appropriateness criteria...
Saved in:
Published in: | JACC. Cardiovascular interventions 2014-09, Vol.7 (9), p.1000-1009 |
---|---|
Main Authors: | , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c455t-a0ec75e6ccf5f727856a9d801f2d6f4673bf1b376c91827f7b6e9da7e333e9543 |
---|---|
cites | cdi_FETCH-LOGICAL-c455t-a0ec75e6ccf5f727856a9d801f2d6f4673bf1b376c91827f7b6e9da7e333e9543 |
container_end_page | 1009 |
container_issue | 9 |
container_start_page | 1000 |
container_title | JACC. Cardiovascular interventions |
container_volume | 7 |
creator | Inohara, Taku, MD Kohsaka, Shun, MD, PhD Miyata, Hiroaki, PhD Ueda, Ikuko, PhD Ishikawa, Shiro, MD, PhD Ohki, Takahiro, MD, PhD Nishi, Yutaro, MD Hayashida, Kentaro, MD, PhD Maekawa, Yuichiro, MD, PhD Kawamura, Akio, MD, PhD Higashi, Takahiro, MD, PhD Fukuda, Keiichi, MD, PhD |
description | Abstract Objectives The aim of this study was to evaluate the appropriateness of percutaneous coronary intervention (PCI) in Japan and clarify the association between trends of pre-procedural noninvasive testing and changes in appropriateness ratings. Background Although PCI appropriateness criteria are widely used for quality-of-care improvement, they have not been validated internationally. Furthermore, the correlation of appropriateness ratings with implementation of newly developed noninvasive testing is unclear. Methods We assigned an appropriateness rating to 11,258 consecutive PCIs registered in the Japanese Cardiovascular Database according to appropriateness use criteria developed in 2009 (AUC/2009) and the 2012 revised version (AUC/2012). Trends of pre-procedural noninvasive testing and appropriateness ratings were plotted; logistic regression was performed to identify inappropriate PCI predictors. Results In nonacute settings, 15% of PCIs were rated inappropriate under AUC/2009, and this percent increased to 30.7% under AUC/2012 criteria. This was mostly because of the focused update of AUC, in which the patients were newly classified as inappropriate if they lacked proximal left anterior descending lesions and did not undergo pre-procedural noninvasive testing. However, these cases were simply not rated under AUC/2009. The amount of inappropriate PCIs increased over 5 years, proportional to the increase in coronary computed tomography angiography use. Use of coronary computed tomography angiography was independently associated with inappropriate PCIs (odds ratio: 1.33; p = 0.027). Conclusions In a multicenter, Japanese PCI registry, approximately one-sixth of nonacute PCIs were rated as inappropriate under AUC/2009, increasing to approximately one-third under the revised AUC/2012. This significant gap may reflect a needed shift in appropriateness recognition of methods for noninvasive pre-procedural evaluation of coronary artery disease. |
doi_str_mv | 10.1016/j.jcin.2014.06.006 |
format | article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1563990982</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1936879814009625</els_id><sourcerecordid>1563990982</sourcerecordid><originalsourceid>FETCH-LOGICAL-c455t-a0ec75e6ccf5f727856a9d801f2d6f4673bf1b376c91827f7b6e9da7e333e9543</originalsourceid><addsrcrecordid>eNp9kc2O0zAUhSMEYoaBF2CBvGST4J_YjiWEVFX8FI0AQRFLy3VuGIfULrZbada8SJ-lT4ajDixYsLKle865Ot-tqqcENwQT8WJsRut8QzFpGywajMW96pJ0UtRSYH6__BUTdSdVd1E9SmksAqwkfVhdUE5ZKyS9rH4tdrsYdtGZDB5SQp9Ndv57QmFAnyDafTYewj6djssQgzfxFq18hngAn13wyPnT8b3ZGY-M79EqJ7RIKdgSN0-_uXyD8g2cjusIZV5CPwTv_MEkdwC0hjQve1w9GMyU4Mnde1V9ffN6vXxXX398u1ourmvbcp5rg8FKDsLagQ-Syo4Lo_oOk4H2Yih12GYgGyaFVaSjcpAbAao3EhhjoHjLrqrn59zS-Oe-7NZblyxM07miJlwwpbDqaJHSs9TGkFKEQRdE29JeE6xn-HrUM3w9w9dY6MK2mJ7d5e83W-j_Wv7QLoKXZwGUlgcHUSfrwFvoXQSbdR_c__Nf_WO3k_POmukH3EIawz76wk8TnajG-st8_vn6pMVYCcrZbzHUr6I</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1563990982</pqid></control><display><type>article</type><title>Appropriateness Ratings of Percutaneous Coronary Intervention in Japan and Its Association With the Trend of Noninvasive Testing</title><source>BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS</source><creator>Inohara, Taku, MD ; Kohsaka, Shun, MD, PhD ; Miyata, Hiroaki, PhD ; Ueda, Ikuko, PhD ; Ishikawa, Shiro, MD, PhD ; Ohki, Takahiro, MD, PhD ; Nishi, Yutaro, MD ; Hayashida, Kentaro, MD, PhD ; Maekawa, Yuichiro, MD, PhD ; Kawamura, Akio, MD, PhD ; Higashi, Takahiro, MD, PhD ; Fukuda, Keiichi, MD, PhD</creator><creatorcontrib>Inohara, Taku, MD ; Kohsaka, Shun, MD, PhD ; Miyata, Hiroaki, PhD ; Ueda, Ikuko, PhD ; Ishikawa, Shiro, MD, PhD ; Ohki, Takahiro, MD, PhD ; Nishi, Yutaro, MD ; Hayashida, Kentaro, MD, PhD ; Maekawa, Yuichiro, MD, PhD ; Kawamura, Akio, MD, PhD ; Higashi, Takahiro, MD, PhD ; Fukuda, Keiichi, MD, PhD</creatorcontrib><description>Abstract Objectives The aim of this study was to evaluate the appropriateness of percutaneous coronary intervention (PCI) in Japan and clarify the association between trends of pre-procedural noninvasive testing and changes in appropriateness ratings. Background Although PCI appropriateness criteria are widely used for quality-of-care improvement, they have not been validated internationally. Furthermore, the correlation of appropriateness ratings with implementation of newly developed noninvasive testing is unclear. Methods We assigned an appropriateness rating to 11,258 consecutive PCIs registered in the Japanese Cardiovascular Database according to appropriateness use criteria developed in 2009 (AUC/2009) and the 2012 revised version (AUC/2012). Trends of pre-procedural noninvasive testing and appropriateness ratings were plotted; logistic regression was performed to identify inappropriate PCI predictors. Results In nonacute settings, 15% of PCIs were rated inappropriate under AUC/2009, and this percent increased to 30.7% under AUC/2012 criteria. This was mostly because of the focused update of AUC, in which the patients were newly classified as inappropriate if they lacked proximal left anterior descending lesions and did not undergo pre-procedural noninvasive testing. However, these cases were simply not rated under AUC/2009. The amount of inappropriate PCIs increased over 5 years, proportional to the increase in coronary computed tomography angiography use. Use of coronary computed tomography angiography was independently associated with inappropriate PCIs (odds ratio: 1.33; p = 0.027). Conclusions In a multicenter, Japanese PCI registry, approximately one-sixth of nonacute PCIs were rated as inappropriate under AUC/2009, increasing to approximately one-third under the revised AUC/2012. This significant gap may reflect a needed shift in appropriateness recognition of methods for noninvasive pre-procedural evaluation of coronary artery disease.</description><identifier>ISSN: 1936-8798</identifier><identifier>EISSN: 1876-7605</identifier><identifier>DOI: 10.1016/j.jcin.2014.06.006</identifier><identifier>PMID: 25234672</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; appropriateness use criteria ; Cardiovascular ; Coronary Angiography - trends ; Diagnostic Imaging - trends ; Female ; Guideline Adherence - trends ; Humans ; Japan ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Outcome and Process Assessment (Health Care) - trends ; Patient Selection ; percutaneous coronary intervention ; Percutaneous Coronary Intervention - trends ; Percutaneous Coronary Intervention - utilization ; Practice Guidelines as Topic ; Practice Patterns, Physicians' - trends ; Predictive Value of Tests ; quality of care ; Registries ; Risk Factors ; Time Factors ; Tomography, X-Ray Computed - trends ; Treatment Outcome ; Unnecessary Procedures - trends</subject><ispartof>JACC. Cardiovascular interventions, 2014-09, Vol.7 (9), p.1000-1009</ispartof><rights>American College of Cardiology Foundation</rights><rights>2014 American College of Cardiology Foundation</rights><rights>Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-a0ec75e6ccf5f727856a9d801f2d6f4673bf1b376c91827f7b6e9da7e333e9543</citedby><cites>FETCH-LOGICAL-c455t-a0ec75e6ccf5f727856a9d801f2d6f4673bf1b376c91827f7b6e9da7e333e9543</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25234672$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Inohara, Taku, MD</creatorcontrib><creatorcontrib>Kohsaka, Shun, MD, PhD</creatorcontrib><creatorcontrib>Miyata, Hiroaki, PhD</creatorcontrib><creatorcontrib>Ueda, Ikuko, PhD</creatorcontrib><creatorcontrib>Ishikawa, Shiro, MD, PhD</creatorcontrib><creatorcontrib>Ohki, Takahiro, MD, PhD</creatorcontrib><creatorcontrib>Nishi, Yutaro, MD</creatorcontrib><creatorcontrib>Hayashida, Kentaro, MD, PhD</creatorcontrib><creatorcontrib>Maekawa, Yuichiro, MD, PhD</creatorcontrib><creatorcontrib>Kawamura, Akio, MD, PhD</creatorcontrib><creatorcontrib>Higashi, Takahiro, MD, PhD</creatorcontrib><creatorcontrib>Fukuda, Keiichi, MD, PhD</creatorcontrib><title>Appropriateness Ratings of Percutaneous Coronary Intervention in Japan and Its Association With the Trend of Noninvasive Testing</title><title>JACC. Cardiovascular interventions</title><addtitle>JACC Cardiovasc Interv</addtitle><description>Abstract Objectives The aim of this study was to evaluate the appropriateness of percutaneous coronary intervention (PCI) in Japan and clarify the association between trends of pre-procedural noninvasive testing and changes in appropriateness ratings. Background Although PCI appropriateness criteria are widely used for quality-of-care improvement, they have not been validated internationally. Furthermore, the correlation of appropriateness ratings with implementation of newly developed noninvasive testing is unclear. Methods We assigned an appropriateness rating to 11,258 consecutive PCIs registered in the Japanese Cardiovascular Database according to appropriateness use criteria developed in 2009 (AUC/2009) and the 2012 revised version (AUC/2012). Trends of pre-procedural noninvasive testing and appropriateness ratings were plotted; logistic regression was performed to identify inappropriate PCI predictors. Results In nonacute settings, 15% of PCIs were rated inappropriate under AUC/2009, and this percent increased to 30.7% under AUC/2012 criteria. This was mostly because of the focused update of AUC, in which the patients were newly classified as inappropriate if they lacked proximal left anterior descending lesions and did not undergo pre-procedural noninvasive testing. However, these cases were simply not rated under AUC/2009. The amount of inappropriate PCIs increased over 5 years, proportional to the increase in coronary computed tomography angiography use. Use of coronary computed tomography angiography was independently associated with inappropriate PCIs (odds ratio: 1.33; p = 0.027). Conclusions In a multicenter, Japanese PCI registry, approximately one-sixth of nonacute PCIs were rated as inappropriate under AUC/2009, increasing to approximately one-third under the revised AUC/2012. This significant gap may reflect a needed shift in appropriateness recognition of methods for noninvasive pre-procedural evaluation of coronary artery disease.</description><subject>Aged</subject><subject>appropriateness use criteria</subject><subject>Cardiovascular</subject><subject>Coronary Angiography - trends</subject><subject>Diagnostic Imaging - trends</subject><subject>Female</subject><subject>Guideline Adherence - trends</subject><subject>Humans</subject><subject>Japan</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Outcome and Process Assessment (Health Care) - trends</subject><subject>Patient Selection</subject><subject>percutaneous coronary intervention</subject><subject>Percutaneous Coronary Intervention - trends</subject><subject>Percutaneous Coronary Intervention - utilization</subject><subject>Practice Guidelines as Topic</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Predictive Value of Tests</subject><subject>quality of care</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed - trends</subject><subject>Treatment Outcome</subject><subject>Unnecessary Procedures - trends</subject><issn>1936-8798</issn><issn>1876-7605</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp9kc2O0zAUhSMEYoaBF2CBvGST4J_YjiWEVFX8FI0AQRFLy3VuGIfULrZbada8SJ-lT4ajDixYsLKle865Ot-tqqcENwQT8WJsRut8QzFpGywajMW96pJ0UtRSYH6__BUTdSdVd1E9SmksAqwkfVhdUE5ZKyS9rH4tdrsYdtGZDB5SQp9Ndv57QmFAnyDafTYewj6djssQgzfxFq18hngAn13wyPnT8b3ZGY-M79EqJ7RIKdgSN0-_uXyD8g2cjusIZV5CPwTv_MEkdwC0hjQve1w9GMyU4Mnde1V9ffN6vXxXX398u1ourmvbcp5rg8FKDsLagQ-Syo4Lo_oOk4H2Yih12GYgGyaFVaSjcpAbAao3EhhjoHjLrqrn59zS-Oe-7NZblyxM07miJlwwpbDqaJHSs9TGkFKEQRdE29JeE6xn-HrUM3w9w9dY6MK2mJ7d5e83W-j_Wv7QLoKXZwGUlgcHUSfrwFvoXQSbdR_c__Nf_WO3k_POmukH3EIawz76wk8TnajG-st8_vn6pMVYCcrZbzHUr6I</recordid><startdate>20140901</startdate><enddate>20140901</enddate><creator>Inohara, Taku, MD</creator><creator>Kohsaka, Shun, MD, PhD</creator><creator>Miyata, Hiroaki, PhD</creator><creator>Ueda, Ikuko, PhD</creator><creator>Ishikawa, Shiro, MD, PhD</creator><creator>Ohki, Takahiro, MD, PhD</creator><creator>Nishi, Yutaro, MD</creator><creator>Hayashida, Kentaro, MD, PhD</creator><creator>Maekawa, Yuichiro, MD, PhD</creator><creator>Kawamura, Akio, MD, PhD</creator><creator>Higashi, Takahiro, MD, PhD</creator><creator>Fukuda, Keiichi, MD, PhD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140901</creationdate><title>Appropriateness Ratings of Percutaneous Coronary Intervention in Japan and Its Association With the Trend of Noninvasive Testing</title><author>Inohara, Taku, MD ; Kohsaka, Shun, MD, PhD ; Miyata, Hiroaki, PhD ; Ueda, Ikuko, PhD ; Ishikawa, Shiro, MD, PhD ; Ohki, Takahiro, MD, PhD ; Nishi, Yutaro, MD ; Hayashida, Kentaro, MD, PhD ; Maekawa, Yuichiro, MD, PhD ; Kawamura, Akio, MD, PhD ; Higashi, Takahiro, MD, PhD ; Fukuda, Keiichi, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-a0ec75e6ccf5f727856a9d801f2d6f4673bf1b376c91827f7b6e9da7e333e9543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>appropriateness use criteria</topic><topic>Cardiovascular</topic><topic>Coronary Angiography - trends</topic><topic>Diagnostic Imaging - trends</topic><topic>Female</topic><topic>Guideline Adherence - trends</topic><topic>Humans</topic><topic>Japan</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Outcome and Process Assessment (Health Care) - trends</topic><topic>Patient Selection</topic><topic>percutaneous coronary intervention</topic><topic>Percutaneous Coronary Intervention - trends</topic><topic>Percutaneous Coronary Intervention - utilization</topic><topic>Practice Guidelines as Topic</topic><topic>Practice Patterns, Physicians' - trends</topic><topic>Predictive Value of Tests</topic><topic>quality of care</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed - trends</topic><topic>Treatment Outcome</topic><topic>Unnecessary Procedures - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Inohara, Taku, MD</creatorcontrib><creatorcontrib>Kohsaka, Shun, MD, PhD</creatorcontrib><creatorcontrib>Miyata, Hiroaki, PhD</creatorcontrib><creatorcontrib>Ueda, Ikuko, PhD</creatorcontrib><creatorcontrib>Ishikawa, Shiro, MD, PhD</creatorcontrib><creatorcontrib>Ohki, Takahiro, MD, PhD</creatorcontrib><creatorcontrib>Nishi, Yutaro, MD</creatorcontrib><creatorcontrib>Hayashida, Kentaro, MD, PhD</creatorcontrib><creatorcontrib>Maekawa, Yuichiro, MD, PhD</creatorcontrib><creatorcontrib>Kawamura, Akio, MD, PhD</creatorcontrib><creatorcontrib>Higashi, Takahiro, MD, PhD</creatorcontrib><creatorcontrib>Fukuda, Keiichi, MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Inohara, Taku, MD</au><au>Kohsaka, Shun, MD, PhD</au><au>Miyata, Hiroaki, PhD</au><au>Ueda, Ikuko, PhD</au><au>Ishikawa, Shiro, MD, PhD</au><au>Ohki, Takahiro, MD, PhD</au><au>Nishi, Yutaro, MD</au><au>Hayashida, Kentaro, MD, PhD</au><au>Maekawa, Yuichiro, MD, PhD</au><au>Kawamura, Akio, MD, PhD</au><au>Higashi, Takahiro, MD, PhD</au><au>Fukuda, Keiichi, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Appropriateness Ratings of Percutaneous Coronary Intervention in Japan and Its Association With the Trend of Noninvasive Testing</atitle><jtitle>JACC. Cardiovascular interventions</jtitle><addtitle>JACC Cardiovasc Interv</addtitle><date>2014-09-01</date><risdate>2014</risdate><volume>7</volume><issue>9</issue><spage>1000</spage><epage>1009</epage><pages>1000-1009</pages><issn>1936-8798</issn><eissn>1876-7605</eissn><abstract>Abstract Objectives The aim of this study was to evaluate the appropriateness of percutaneous coronary intervention (PCI) in Japan and clarify the association between trends of pre-procedural noninvasive testing and changes in appropriateness ratings. Background Although PCI appropriateness criteria are widely used for quality-of-care improvement, they have not been validated internationally. Furthermore, the correlation of appropriateness ratings with implementation of newly developed noninvasive testing is unclear. Methods We assigned an appropriateness rating to 11,258 consecutive PCIs registered in the Japanese Cardiovascular Database according to appropriateness use criteria developed in 2009 (AUC/2009) and the 2012 revised version (AUC/2012). Trends of pre-procedural noninvasive testing and appropriateness ratings were plotted; logistic regression was performed to identify inappropriate PCI predictors. Results In nonacute settings, 15% of PCIs were rated inappropriate under AUC/2009, and this percent increased to 30.7% under AUC/2012 criteria. This was mostly because of the focused update of AUC, in which the patients were newly classified as inappropriate if they lacked proximal left anterior descending lesions and did not undergo pre-procedural noninvasive testing. However, these cases were simply not rated under AUC/2009. The amount of inappropriate PCIs increased over 5 years, proportional to the increase in coronary computed tomography angiography use. Use of coronary computed tomography angiography was independently associated with inappropriate PCIs (odds ratio: 1.33; p = 0.027). Conclusions In a multicenter, Japanese PCI registry, approximately one-sixth of nonacute PCIs were rated as inappropriate under AUC/2009, increasing to approximately one-third under the revised AUC/2012. This significant gap may reflect a needed shift in appropriateness recognition of methods for noninvasive pre-procedural evaluation of coronary artery disease.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25234672</pmid><doi>10.1016/j.jcin.2014.06.006</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1936-8798 |
ispartof | JACC. Cardiovascular interventions, 2014-09, Vol.7 (9), p.1000-1009 |
issn | 1936-8798 1876-7605 |
language | eng |
recordid | cdi_proquest_miscellaneous_1563990982 |
source | BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS |
subjects | Aged appropriateness use criteria Cardiovascular Coronary Angiography - trends Diagnostic Imaging - trends Female Guideline Adherence - trends Humans Japan Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Outcome and Process Assessment (Health Care) - trends Patient Selection percutaneous coronary intervention Percutaneous Coronary Intervention - trends Percutaneous Coronary Intervention - utilization Practice Guidelines as Topic Practice Patterns, Physicians' - trends Predictive Value of Tests quality of care Registries Risk Factors Time Factors Tomography, X-Ray Computed - trends Treatment Outcome Unnecessary Procedures - trends |
title | Appropriateness Ratings of Percutaneous Coronary Intervention in Japan and Its Association With the Trend of Noninvasive Testing |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T02%3A45%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Appropriateness%20Ratings%20of%20Percutaneous%C2%A0Coronary%20Intervention%20in%C2%A0Japan%20and%20Its%20Association%20With%20the%C2%A0Trend%20of%20Noninvasive%20Testing&rft.jtitle=JACC.%20Cardiovascular%20interventions&rft.au=Inohara,%20Taku,%20MD&rft.date=2014-09-01&rft.volume=7&rft.issue=9&rft.spage=1000&rft.epage=1009&rft.pages=1000-1009&rft.issn=1936-8798&rft.eissn=1876-7605&rft_id=info:doi/10.1016/j.jcin.2014.06.006&rft_dat=%3Cproquest_cross%3E1563990982%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c455t-a0ec75e6ccf5f727856a9d801f2d6f4673bf1b376c91827f7b6e9da7e333e9543%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1563990982&rft_id=info:pmid/25234672&rfr_iscdi=true |