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Regional variations in physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators.

Publication ,  Journal Article
Matlock, DD; Kutner, JS; Emsermann, CB; Al-Khatib, SM; Sanders, GD; Dickinson, LM; Rumsfeld, JS; Davidson, AJ; Crane, LA; Masoudi, FA
Published in: J Card Fail
April 2011

INTRODUCTION: This study was designed to determine if physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators (ICDs) are regionally associated with ICD use. METHODS AND RESULTS: A national sample of 9969 members of the American College of Cardiology was surveyed electronically. Responses were merged with rates of ICD implantation from the National Cardiovascular Data Registry. Multivariable regression was used to assess trends between regional use and responses. We received 1210 responses (12%) and used 1124 after exclusions. Across regions, physicians were equally likely to recommend ICDs to males or females with ischemic (∼99% for both; P = NS) or nonischemic cardiomyopathy (85 vs. 88% P = 0.85). Significant increasing trends in the probability recommending ICD therapy were found when the patient was "frail" (21% to 32%; P = .03) or had a life expectancy <1 year (5% to 10%; P = .05). These differences were not associated with attitudes toward ICDs. CONCLUSIONS: Independent of variations in physicians' attitudes towards ICDs, physicians in regions of low ICD use are not less likely to recommend ICDs in situations clearly supported by guidelines while those in regions of high ICD use are more likely to recommend ICDs to patients who might have limited benefit.

Duke Scholars

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

April 2011

Volume

17

Issue

4

Start / End Page

318 / 324

Location

United States

Related Subject Headings

  • Practice Patterns, Physicians'
  • Multivariate Analysis
  • Male
  • Humans
  • Health Care Surveys
  • Female
  • Defibrillators, Implantable
  • Cardiovascular System & Hematology
  • Cardiology
  • Attitude of Health Personnel
 

Citation

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Matlock, D. D., Kutner, J. S., Emsermann, C. B., Al-Khatib, S. M., Sanders, G. D., Dickinson, L. M., … Masoudi, F. A. (2011). Regional variations in physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators. J Card Fail, 17(4), 318–324. https://doi.org/10.1016/j.cardfail.2010.11.009
Matlock, Dan D., Jean S. Kutner, Caroline B. Emsermann, Sana M. Al-Khatib, Gillian D. Sanders, L Miriam Dickinson, John S. Rumsfeld, Arthur J. Davidson, Lori A. Crane, and Frederick A. Masoudi. “Regional variations in physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators.J Card Fail 17, no. 4 (April 2011): 318–24. https://doi.org/10.1016/j.cardfail.2010.11.009.
Matlock DD, Kutner JS, Emsermann CB, Al-Khatib SM, Sanders GD, Dickinson LM, et al. Regional variations in physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators. J Card Fail. 2011 Apr;17(4):318–24.
Matlock, Dan D., et al. “Regional variations in physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators.J Card Fail, vol. 17, no. 4, Apr. 2011, pp. 318–24. Pubmed, doi:10.1016/j.cardfail.2010.11.009.
Matlock DD, Kutner JS, Emsermann CB, Al-Khatib SM, Sanders GD, Dickinson LM, Rumsfeld JS, Davidson AJ, Crane LA, Masoudi FA. Regional variations in physicians' attitudes and recommendations surrounding implantable cardioverter-defibrillators. J Card Fail. 2011 Apr;17(4):318–324.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

April 2011

Volume

17

Issue

4

Start / End Page

318 / 324

Location

United States

Related Subject Headings

  • Practice Patterns, Physicians'
  • Multivariate Analysis
  • Male
  • Humans
  • Health Care Surveys
  • Female
  • Defibrillators, Implantable
  • Cardiovascular System & Hematology
  • Cardiology
  • Attitude of Health Personnel