the cycle of cardiac care and the uninformed patient
DESCRIPTION
Presentation given at the Foundation's Jan. 26, 2011 Research and Policy Forum by Shannon Brownlee, MS, acting director of the New America Health Policy Program and nationally known writer and essayist.TRANSCRIPT
![Page 1: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/1.jpg)
Adventures in Cardiology: What SDM Means to Patients
Shannon Brownlee, MSActing Director, New America Foundation
Health Policy ProgramInstructor, The Dartmouth Institute for Health
Policy and Clinical Practice
![Page 2: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/2.jpg)
Happy Cardiology News
![Page 3: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/3.jpg)
REDDING, CALIFORNIA
![Page 4: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/4.jpg)
![Page 5: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/5.jpg)
![Page 6: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/6.jpg)
Senate Finance Committee: “Midei may have implanted 585 stents which were medically unnecessary”
![Page 7: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/7.jpg)
H. Vernon Anderson et al Circulation 2005;112;2786-2791
Relationship Between Procedure Indications and Outcomes of Percutaneous Coronary Interventions by American College of Cardiology/American Heart Association Task Force Guidelines
![Page 8: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/8.jpg)
Cardiologists’ Use of PCI for Stable Coronary Artery Disease
“Yes, medical therapy is as effective as PCI, but when I see a lesion, the bottom line is that the oculostenotic reflex always wins out.”
“[The patient] is not going to get out of the cath lab without a stent.”
Grace A. Lin, et al ARCH INTERN MED/VOL 167 (NO. 15), AUG 13/27, 2007
![Page 9: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/9.jpg)
Well Bob, it looks like a paper cut, but just to be sure, let’s do lots of catheterizations.
![Page 10: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/10.jpg)
•Only 31% had activity limiting chest pain •Cardiologists’ perception of the patient’s angina was often greater than the patient’s
MB Rothberg Ann Intern Med. 2010 Sep 7;153(5):307-1
![Page 11: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/11.jpg)
“Guidelines must be living documents; they must continue to evolve to meet the needs of interventional cardiologists faced with increasingly complex patients . . .”Circulation 2005;112;2754-2755
![Page 12: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/12.jpg)
H. Vernon Anderson et al Circulation 2005;112;2786-2791
Relationship Between Procedure Indications and Outcomes of Percutaneous Coronary Interventions by American College of Cardiology/American Heart Association Task Force Guidelines
![Page 13: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/13.jpg)
MARILDA
![Page 14: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/14.jpg)
![Page 15: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/15.jpg)
![Page 16: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/16.jpg)
![Page 17: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/17.jpg)
![Page 18: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/18.jpg)
HEALTH CARE
Busting Budgets
![Page 19: The Cycle of Cardiac Care and the Uninformed Patient](https://reader036.vdocuments.net/reader036/viewer/2022062513/55652421d8b42a767f8b477f/html5/thumbnails/19.jpg)
$8,600 – 14,300
$7,800 – 8,600
$7,200 – 7,800
$6,600 – 7,200
$5,280 – 6,600
Not populated
THANK YOU!!
Source: Dartmouth Atlas