A study, published in JAMA Cardiology, examined interventional cardiologists' views on how public reporting of percutaneous coronary intervention outcomes affects decision making.
Researchers conducted an online survey of interventional cardiologists in Massachusetts and New York. Researchers used Doximity, an online physician networking site, and 2014 Medicare fee-for-service claims for PCI procedures to identify the physicians. Of 456 physicians approached, 149 responded. Most participants reported practicing at medium or large nonprofit hospitals.
Here are four survey findings:
1. In 2014, respondents reported higher annual PCI volumes among Medicare patients than nonrespondents did.
2. Among survey participants, 65 percent reported avoiding PCIs on at least two occasions because of concern a bad outcome would negatively impact their publicly reported outcomes.
3. Additionally, 59 percent reported sometimes or often being pressured by colleagues to avoid performing PCIs because of concern about the patient's risk of death.
4. Analysis of survey results showed more experience practicing interventional cardiology was associated with lower odds of PCI avoidance.
"Current PCI public reporting programs can foster risk-averse clinical practice patterns, which do not vary significantly between interventional cardiologists in New York and Massachusetts," study authors concluded.