Progression of peripheral arterial disease predicts cardiovascular disease morbidity and mortality.

Objectives: The purpose of this study was to examine the association of progressive versus stable peripheral arterial disease (PAD) with the risk of future cardiovascular disease (CVD) events.

Background: An independent association between PAD, defined by low values of the ankle-brachial index (ABI), and future CVD risk has been demonstrated. However, the prognostic significance of declining versus stable ABI has not been studied.

Poisoning hospitalization correlates with poison center call frequency.

Introduction: Poison Control Centers (PCCs) have been shown to reduce health expenditures by reducing emergency department and clinic visits. The effect or association of PCC call frequency on acute hospitalization rates for poisonings has not been studied extensively.

Methods: All nonfederal hospital discharges for acute poisoning principal diagnosis codes (960-979, 980-989, 9956X, 3030, and 005) in California between October 1999 and June 2002 were examined.

Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey.

Background: The combination of cardiovascular risk factors known as the metabolic syndrome is receiving increased attention from physicians, but data on the syndrome's association with morbidity are limited.

Methods And Results: Applying National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria, we evaluated 10 357 NHANES III subjects for the 5 component conditions of the metabolic syndrome: insulin resistance, abdominal obesity based on waist circumference, hypertriglyceridemia, low HDL cholesterol (HDL-C), and hypertension, as well as the full syndrome, defined as at least 3 of the 5 conditions. Logistic regression was used to estimate the cross-sectional association of the syndrome and each of its 5 component conditions separately with history of myocardial infarction (MI), stroke, and either MI or stroke (MI/stroke).

Profiling care provided by different groups of physicians: effects of patient case-mix (bias) and physician-level clustering on quality assessment results.

Background: Patient characteristics (case-mix bias) and physician-level variation (clustering) are often overlooked in profiling the quality of care provided by different groups of physicians, such as specialties.

Objective: To examine the effect of case-mix bias and physician-level clustering on differences in quality of diabetes care between specialty groups participating in the American Diabetes Association's Provider Recognition Program.

Design: Retrospective record review of both process and outcome measures over 1 year and a cross-sectional patient survey.