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Racial differences in cardiac catheterization use and appropriateness.

Ferguson JA, Adams TA, Weinberger M. Racial differences in cardiac catheterization use and appropriateness. The American journal of the medical sciences. 1998 May 1; 315(5):302-6.

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The authors sought to investigate the role of medical appropriateness as a potential explanatory factor in previously observed interracial cardiac procedure rate differences. A retrospective cohort study using RAND appropriateness criteria was conducted at a Veterans Affairs medical center among a sample of patients who were evaluated for cardiovascular disease during 1993 (n = 200). All participants were men and 50% were black (mean age = 61.8 years). Blacks were less likely than whites to undergo cardiac catheterizations (CC) (odds ratio [OR] = 0.23, P < 0.01). When RAND criteria were applied, blacks were found to have fewer indications that made them appropriate candidates for CC and more indications making them inappropriate candidates for CC (chi-square test, P < 0.05). No CC procedure underuse was found among blacks, whereas 10% of CC overuse was found among whites. Interracial CC procedure use differences were not due to procedure underuse among blacks but were in part due to overuse among whites.

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