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Correspondence
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Volume 344:774-775 March 8, 2001 Number 10
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Appropriateness of Coronary Angiography after Myocardial Infarction among Medicare Beneficiaries

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To the Editor: In their article on the appropriateness of coronary angiography after myocardial infarction among Medicare beneficiaries (Nov. 16 issue),1 Guadagnoli et al. fail to acknowledge several important limitations of their study. First, the data are from 1994 and 1995. The way in which members of managed-care plans are served has changed radically since then, as have the practice patterns of cardiologists. To imply that we can now use the study's results to make decisions for 2001 and beyond is incorrect.

Second, the authors make no attempt to investigate the risk structures for the Medicare beneficiaries who were studied. . . . [Full Text of this Article]

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