Potential Pitfall of Using National Databases to Monitor Non-Evidence-Based Treatment

Multi‐Center, Community‐Based Cardiac Implantable Electronic Devices Registry: Population, Device Utilization, and Outcomes

“…Another example was the KP‐CDR's ability to more accurately report the true rate of non‐evidence‐based implants to each center. For example, while it has been reported that non‐evidence‐based primary prevention ICDs from the ACC‐NCDR registry is as high as 22.5% nationally, the KP rate from the same ACC‐NCDR criteria was 8.8% . However, when the submitted data were validated through the KP‐CDR, which was dependent on clinically active EMR information and not a separate data form or manual submission, the actual rate was 3.1%.…”

“…For example, while it has been reported that nonevidence-based primary prevention ICDs from the ACC-NCDR registry is as high as 22.5% 17 nationally, the KP rate from the same ACC-NCDR criteria was 8.8%. 18 However, when the submitted data were validated through the KP-CDR, which was dependent on clinically active EMR information and not a separate data form or manual submission, the actual rate was 3.1%. This information allowed physicians to further evaluate a true sample of cases for reasons and rationales for either breaking those guidelines based on clinical judgment or effect change in practice patterns.…”