Plus, What Consumers Can Do To Avoid Hyped High-Tech Cardiac Tests and Treatments They May Not Need
YONKERS, N.Y., Sept. 7 /PRNewswire-USNewswire/ -- The Consumer Reports Health Ratings Center today unveiled its first doctor ratings based on a new collaboration with The Society of Thoracic Surgeons (STS), publishing a list of fifty top-rated heart-bypass surgical groups in the U.S. The surgeon ratings plus advice about treating heart disease are available in the October issue of Consumer Reports and online at www.consumerreportsenespanol.org. Consumer Reports Health also has advice on getting the right care to treat heart disease, the number one killer in the U.S., noting that consumers should be wary of hyped high-tech tests and treatments that may be unnecessary and costly.
Launched in 2008, the Consumer Reports Health Ratings Center has rated more than 3,000 U.S. hospitals, as well as prescription drugs to treat more than 35 conditions. "We've wanted to do doctor ratings since we launched the Ratings Center because there is such great consumer demand. Starting with heart surgeons made the most sense because the data is top notch," said John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center.
Consumer Reports Health collaborated with STS to publish its ratings of 221 surgical groups in the U.S. that perform standard heart bypass operations known as coronary artery bypass grafting (CABG). The ratings are based on 11 standardized measures that fall into four categories. Two of them—recommended medications and optimal surgical technique—reflect how well surgeons adhere to the best-established practices. The other two—patient survival and the absence of surgical complications—reflect how their patients fare. There are over 1,000 surgical groups in the U.S. that perform heart bypass surgery and approximately 90 percent of those groups voluntarily submit their performance data to the STS Adult Cardiac Surgery Database. A little less than one quarter of those groups (221) agreed to allow Consumer Reports Health to publish their results.
FIFTY HEART SURGEON GROUPS GIVEN TOP MARKS
Groups that score significantly above average receive a three star rating, while average performers get two stars, and those that score significantly below average get one star. Consumer Reports Health notes that since the average performance of surgical groups has increased substantially in the past two decades, it's possible to get very good care from many two star groups.
Of the 221 groups, 50 received three stars, 166 were given two stars, and five garnered one star. If a consumer is considering a group that is not rated, they should ask that group for its results. "Those groups should be willing to provide their results, and if they can't share their information, then it's best to look elsewhere," said Santa.
ABOUT THE RATINGS
The STS has maintained the Adult Cardiac Surgery Database, the largest such registry, since 1989. "The Society of Thoracic Surgeons has created a model of reporting results, in part because they're drawing on an extensive database with a large volume of patient records and because much of the data is collected at the point of care. And for each of the eleven measures, STS compares a group's performance with the average performance of all the groups in the database, which allows us to give consumers some benchmarking," said Santa.
"These days it's much easier for a consumer to make an informed decision about a car or a vacuum than a health care provider," said Santa. And while there are many doctor ratings available on the Web, their value as a tool for choosing a doctor is questionable. Ratings based on reputation place an emphasis on relationships, rather than on actual performance. Sites that provide user reviews can be tricky, as they tend to consist of reviews that are either very positive or very negative. "I'm concerned about consumers relying on such ratings because they don't provide a valid sample of experiences. And they rarely involve risk adjustment, taking into account the overall health of a group's patients. We felt that this was an important component of the STS ratings."
Consumer Reports Health also provides guidance on treating heart disease. The report, available online at www.ConsumerReportsHealth.org, identifies the common symptoms of a heart attack and what to do if you suspect you're having one. Cardiovascular disease remains the number one killer in the U.S. in part because heart attack victims often don't recognize the symptoms and delay getting care.
GETTING THE RIGHT TESTS
It goes without saying that it's better to identify heart disease before you have an attack. But that's not always easy, in part because there are so many tests available, some of which are widely touted in direct-to-consumer ads. Consumer Reports Health notes that hyped high-tech tests and treatments are sometimes ordered because doctors and hospitals have a financial incentive to keep the gadgets humming and because of persistent, but outdated notions. Consumer Reports Health evaluates the following tests:
CT coronary angiography, a noninvasive test that provides a three-dimensional image of the heart, is widely touted in direct-to-consumer ads. But it carries a hefty radiation dose and can register false positive results that can lead to additional invasive tests and procedures.
Stress tests measure the heart's function while it's stressed by exercise or possibly medication. Some doctors use it for people with no heart symptoms as part of a routine exam. That's generally not advisable because the test is not as accurate in low-risk people and can lead to further follow up testing that can be unnecessary and expensive. For people with symptoms of heart disease, though, a stress test should usually be the first test ordered.
Coronary angiography is the gold standard for confirming heart disease in people with worrisome stress test results, but going straight to such an invasive test is warranted only for people at a very high risk of heart disease or have symptoms or an underlying condition that could make stress testing risky.
CT angiography and electron beam computed tomography have almost no role in treating people without symptoms of heart disease and are of limited use even for those who do have them. Even in people with suspected heart disease, results of CT angiography are often so uncertain that the test has to be followed up with standard angiography.
About the Consumer Reports Health Ratings Center
The Consumer Reports Health Ratings Center (www.ConsumerReportsHealth.org) currently provides Best Buy Drugs (BBD) ratings on prescription medications for more than 35 medical conditions; Ratings of more than 3,000 U.S. hospitals; Ratings for a wide array of healthy living products from fitness equipment to sunscreens; thousands of natural medicines; and treatment options for more than 200 conditions and diseases.
About the Society of Thoracic Surgeons
The Society of Thoracic Surgeons is a not-for-profit organization representing more than 6,000 surgeons, researchers and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus as well as other surgical procedures within the chest. Founded in 1964, the mission of STS is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.
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SOURCE Consumer Reports Health