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Looking for Answers in All the Wrong Places

Peter E. Dans, MD, Deputy Editor
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Annals of Internal Medicine, Philadelphia, PA 19106. Requests for Reprints: Peter E. Dans, MD, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106-1572.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;119(8):855-857. doi:10.7326/0003-4819-119-8-199310150-00014
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An old vaudeville story describes a man groping on all fours beneath a lamppost looking for a quarter he had dropped a block away. When asked his reason for searching there, he responded, because the light's better. The article by Jollis and colleagues [1] in this issue of Annals brings this story to mind. They and other members of the cardiology division at Duke University have for years prospectively accumulated a rich clinical database for managing patients with cardiovascular disease. Consequently, they were in a unique position to answer the Agency for Health Care Policy and Research's call of PORT (Patient Outcome Research Team) initiative to use the massive Medicare billing database to answer questions about effectiveness and outcome for patients with ischemic heart disease [2]. Their study shows, not surprisingly, that data sets completed for billing purposes and constructed mainly by financial experts differ substantially from those constructed by clinicians caring for patients.

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