By W. Douglas Weaver, MD, MACC, chair of the CathPCI Registry Steering Committee and former ACC president

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Beginning in May, the NCDR CathPCI Registry reports will provide participating hospitals the ability to compare their performance against peer hospitals using ACC’s Coronary Revascularization Appropriate Use Criteria (AUC). These AUC are based on the Coronary Revascularization Guideline, and are intended to show whether PCI was appropriate, inappropriate or uncertain for each patient entered into the registry database.

This is important for a number of reasons. As can hardly be missed, the overuse of stenting has been suggested in several places and been the subject of state investigations both in Maryland and most recently, in Pennsylvania. Inclusion of AUC metrics in the CathPCI Registry is one step being taken by the ACC to enable well-intentioned cardiovascular professionals to determine whether their case mix of appropriate use is similar to other sites in the registry and enables them to benchmark performance. The data will be reported at the hospital level, but will also include a listing of the inappropriate cases, which will allow the hospital and interventionalists to review any such cases.

There are some important caveats. The metrics are currently considered “test metrics,” meaning that we’ll be modifying them if we determine from feedback that some of the data was either inaccurate or incomplete. To do this, we’ll be leaning heavily on CathPCI participants to make sure that they are vigilant in providing the highest quality of data possible. At this time, we believe that the metrics are not valid to be used in health plan payment programs or for public reporting purposes. The ACC will be using the experience gained during the metric testing phase to refine and enhance the value of AUC to aid professionals in improving quality of care and enhancing patient outcomes.

The ultimate goal is two-fold: offer a greater value to participating hospitals and physicians in the CathPCI Registry and to improve the quality of care provided to patients with cardiovascular disease. More information is available on the NCDR website.

If you’re interested in learning more of the topic, I encourage you to attend a session with Paul Chan, MD, FACC: “Appropriateness of PCI in the U.S.: Insights from the NCDR CathPCI Registry,” from 8-9:30 a.m. tomorrow in Room 238.

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