Challenges of Interpreting Results From Analyses That Use Extensive Claims Data
Authors: Kevin W. Lobdell
Journal: Annals of Internal Medicine (2009)

Letters15 December 2009Challenges of Interpreting Results From Analyses That Use Extensive Claims DataKevin W. Lobdell, MD, Eric Skipper, MD, Mark Reames, MD, R. Mark Stiegel, MD, Jeko Madjarov, MD, Sara Camp, MSN, Francis Robicsek, MD, PhD, and Sotiris Stamou, MD, PhDKevin W. Lobdell, MDFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this author, Eric Skipper, MDFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this author, Mark Reames, MDFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this author, R. Mark Stiegel, MDFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this author, Jeko Madjarov, MDFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this author, Sara Camp, MSNFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this author, Francis Robicsek, MD, PhDFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this author, and Sotiris Stamou, MD, PhDFrom Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-12-200912150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Auerbach and colleagues (1) focus on important process and outcome measures in surgical coronary artery revascularization but neglect to address some very practical limitations of the extensive administrative data. Specifically, quality measures related to statins, aspirin, and β-blockers given within 2 days of surgery are of limited value if taken out of context. A clinical situation may sometimes exclude a patient from 1 of the treatments even when the exclusion criteria do not address these issues. For example, patients who remain mechanically ventilated would not typically be given a lipid-lowering agent, patients with significant postoperative thrombocytopenia or ...Reference1. Auerbach AD, Hilton JF, Maselli J, Pekow PS, Rothberg MB, Lindenauer PK. Shop for quality or volume? Volume, quality, and outcomes of coronary artery bypass surgery. Ann Intern Med. 2009;150:696-704. [PMID: 19451576] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Carolinas Heart and Vascular Institute, Charlotte, NC 28232; and Missouri Baptist Medical Center, St. Louis, MO 63131.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoShop for Quality or Volume? Volume, Quality, and Outcomes of Coronary Artery Bypass Surgery Andrew D. Auerbach , Joan F. Hilton , Judith Maselli , Penelope S. Pekow , Michael B. Rothberg , and Peter K. Lindenauer Challenges of Interpreting Results From Analyses That Use Extensive Claims Data Andrew D. Auerbach , Michael B. Rothberg , and Peter K. Lindenauer Metrics 15 December 2009Volume 151, Issue 12Page: 895KeywordsCoagulopathyEpinephrineNorepinephrinePlateletsRevascularizationStatinsSurgeonsSurgery ePublished: 15 December 2009 Issue Published: 15 December 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...