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Heart Stress Test Likelier When Doctor Owns Equipment: Study
Date:11/9/2011

By Amanda Gardner
HealthDay Reporter

TUESDAY, Nov. 8 (HealthDay News) -- Doctors who own equipment for cardiac stress tests are more likely to perform the tests, even when guidelines don't recommend it.

The same was true if the doctor didn't necessarily own the equipment but did interpret the results in his or her own office, according to a study in the Nov. 9 issue of the Journal of the American Medical Association.

The authors of the study looked specifically at patients who had recently undergone revascularization procedures to open blocked arteries.

There are no recommendations to support routine testing of patients with no symptoms within two years of having a procedure such as balloon angioplasty or receiving stents, or within five years of having coronary artery bypass surgery.

It's well known that imaging has exploded in many areas of medicine, particularly cardiology. The trend has also been linked previously to physician reimbursement.

One recent study found that doctors are far more likely to refer patients complaining of lower back pain for an expensive MRI scan if they own or lease such imaging equipment.

The authors of the new study looked at data on nearly 18,000 patients enrolled in a national insurance plan, UnitedHealthcare, which also funded the study, who had undergone revascularization within the past several months.

The data only included procedures performed between 2004 and 2007. Guidelines for routine testing after such a procedure weren't introduced until 2007.

Two types of tests were looked at: nuclear stress testing (which uses radioactive material to see blood flow) and stress echocardiography (which uses ultrasound), but the authors reported results only on nuclear, which was the most common test in this group, according to study lead author Dr. Bimal R. Shah, an assistant professor of medicine at Duke University Medical Center.

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