Temporal Trends in Percutaneous Coronary Intervention Appropriateness: Insights From the Clinical Outcomes Assessment Program.

Background: It is unknown whether the appropriate use of percutaneous coronary intervention (PCI) has improved over time and whether trends in PCI appropriateness have been accompanied by changes in the use of PCI.

Methods And Results: We applied appropriate use criteria to determine the appropriateness of all 51 872 PCI performed in Washington State from 2010 through 2013. We evaluated the number of PCIs performed from 2006 through 2013 to provide a comparator period that preceded statewide appropriateness assessment beginning in 2010.

A primer on using shrinkage to compare in-hospital mortality between centers.

Outcomes of cardiothoracic surgery are usually compared among hospitals or physicians by reporting the frequency of in-hospital mortality. Although there is agreement that these frequencies should be adjusted for case mix, there remains uncertainty about the value of using a statistical model that represents hospitals as random effects as opposed to the conventional approach of fixed effects. For years, the Northern New England Cardiovascular Disease Study Group has compared in-hospital mortality after coronary artery bypass graft surgery among centers using a fixed effects approach.

Evaluation of the South Dakota fitCare child care provider training program targeting nutrition and physical activity.

Introduction: Early childhood obesity is a significant health problem that has serious short- and long-term consequences. Recognizing the influence child care providers have on children, state programs have been created through federal funding initiatives to improve childhood health and reduce obesity rates. In 2011, South Dakota Department of Health received a five-year Centers for Disease Control and Prevention Community Transformation grant to improve healthy eating and active living.

Health-compromising behaviors among young adults in the urban emergency department: opportunity for a teachable moment.

Emergency departments (ED) are a point of care for many young adults and may provide a teachable moment leading to behavioral change. We determined the descriptive epidemiology of health-compromising behaviors in the young adult ED population by computing demographic-adjusted estimates of prevalence and frequency of hazardous drinking, risky driving, cigarette smoking, fast-food consumption, lack of exercise, and sleep deficit. We screened 8,815 young adults during an ED visit.