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Racial Differences in Cardiac Revascularization Rates: Does “Overuse” Explain Higher Rates among White Patients?

Eric C. Schneider, MD, MSc; Lucian L. Leape, MD; Joel S. Weissman, PhD; Robert N. Piana, MD; Constantine Gatsonis, PhD; and Arnold M. Epstein, MD, MA
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From Brigham and Women's Hospital, Harvard School of Public Health, and Massachusetts General Hospital, Boston, Massachusetts; and Brown University, Providence, Rhode Island.


Acknowledgments: The authors thank David Bates for comments on an earlier version of the manuscript; Margaret Volya and Jie Zheng for programming assistance; Marissa Hendrickson and Andrew Ellner for assistance with data collection; Marian Hendershot and the staff of the participating Peer Review Organizations, without whom this project would not have been possible; and Jeffrey Adams and Anne Hudson for assistance in preparing the manuscript.

Grant Support: By grant 5-RO-HS07098-02S1 from the Agency for Health Care Policy and Research.

Requests for Single Reprints: Eric C. Schneider, MD, MSc, Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.

Current Author Addresses: Drs. Schneider, Leape, and Epstein: Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.

Dr. Weissman: Institute for Health Policy, Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA 02115.

Dr. Piana: Division of Cardiology, Vanderbilt University Medical Center, 2311 Pierce Avenue, Nashville, TN 37232-8802.

Dr. Gatsonis: Center for Statistical Sciences, Brown University Box G-H, 167 Angell Street, 2nd Floor, Providence, RI 02912.

Author Contributions: Conception and design: E.C. Schneider, L.L. Leape, J.S. Weissman, C. Gatsonis, A.M. Epstein.

Analysis and interpretation of the data: E.C. Schneider, L.L. Leape, J.S. Weissman, R.N. Piana, C. Gatsonis, A.M. Epstein.

Drafting of the article: E.C. Schneider, J.S. Weissman, A.M. Epstein.

Critical revision of the article for important intellectual content: E.C. Schneider, L.L. Leape, J.S. Weissman, R.N. Piana, C. Gatsonis, A.M. Epstein.

Final approval of the article: E.C. Schneider, L.L. Leape, J.S. Weissman, C. Gatsonis, A.M. Epstein.

Statistical expertise: C. Gatsonis.

Obtaining of funding: C. Gatsonis, A.M. Epstein.

Administrative, technical, or logistic support: E.C. Schneider, A.M. Epstein.

Collection and assembly of data: E.C. Schneider, J.S. Weissman, R.N. Piana, A.M. Epstein.


Ann Intern Med. 2001;135(5):328-337. doi:10.7326/0003-4819-135-5-200109040-00009
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Coronary artery bypass graft (CABG) surgery and percutaneous transluminal coronary angioplasty (PTCA) are well-established and widely used treatments for symptomatic coronary artery disease (13). In the United States during 1998, 553 000 CABG surgeries and 539 000 PTCA procedures were performed. Fifty-three percent of these procedures were performed in patients 65 years of age or older (4).

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Figure.
Revascularization rates and share of procedures rated appropriate, uncertain, and inappropriate by race.

CABG = coronary artery bypass graft; PTCA = percutaneous transluminal coronary angioplasty.

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Summary for Patients

Overuse of Coronary Artery Bypass Graft Surgery and Percutaneous Transluminal Coronary Angioplasty

The summary below is from the full report titled “Racial Differences in Cardiac Revascularization Rates: Does ‘Overuse’ Explain Higher Rates among White Patients?” It is in the 4 September 2001 issue of Annals of Internal Medicine (volume 135, pages 328-337). The authors are EC Schneider, LL Leape, JS Weissman, RN Piana, C Gatsonis, and AM Epstein.

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