The appropriateness of performing coronary angiography in two major teaching hospitals in Israel.
OBJECTIVE
To assess the appropriateness of using coronary angiography in two major medical centers in Israel.


METHODS
(a) Development of dichotomous appropriateness rating by concensus of an expert panel for possible indications to use coronary angiography; (b) applying the panel's rating to clinical data gathered from interviews and records of 499 patients who underwent coronary angiography.


RESULTS
Angiographies were performed inappropriately in 58% of patients: in 56% neither prognostic stratification was performed, nor was comprehensive medical therapy prior to angiography undertaken. Referral to catheterization from an acute care hospital, compared to ambulatory referral, correlated independently with an inappropriate angiogram.


CONCLUSIONS
In the Israeli public health system there is still a high rate of inappropriate coronary angiography, most of the cases being due to error in management before performing angiographies.
Mozes
B
B
Gertner Institute, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
Shabtai
E
E
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging; D006328:Cardiac Catheterization / Q000706:statistics & numerical data; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D007557:Israel; D008297:Male; D008329:Managed Care Programs / Q000639:trends; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012017:Referral and Consultation / Q000706:statistics & numerical data