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Public reporting of percutaneous coronary interventions

David Enze Wang, Rishi K Wadhera and Deepak L Bhatt
Med J Aust 2018; 209 (3): 104-105. || doi: 10.5694/mja18.00569
Published online: 6 August 2018

Despite enhancing transparency, public reporting may be leading to avoidance of life-saving procedures

In the United States, public reporting of percutaneous coronary interventions (PCI) has been implemented in several states to enhance transparency and accountability, with the intent of improving patient outcomes. However, the impact of public reporting remains a controversial issue. A growing body of evidence suggests that public reporting has not improved patient outcomes. In fact, robust evidence shows that it has instead led to risk aversion. Public reporting of PCI stands at the crossroads of competing priorities. By the principle of beneficence — “doing good” — public reporting seeks to enhance transparency, but it may violate the principle of non-maleficence — “do no harm” — through the unintended consequence of avoidance of high risk patients.

  • David Enze Wang1
  • Rishi K Wadhera2
  • Deepak L Bhatt1

  • 1 Harvard University, Boston, Mass, USA
  • 2 Heart and Vascular Center, Brigham and Women's Hospital, Boston, Mass, USA


Competing interests:

Deepak Bhatt discloses the following relationships — advisory board: Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, Regado Biosciences; board of directors: Boston VA Research Institute, Society of Cardiovascular Patient Care; chair: American Heart Association Quality Oversight Committee; data monitoring committees: Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Cleveland Clinic, Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine, Population Health Research Institute; honoraria: American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Vice-Chair, ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim), Belvoir Publications (Editor-in-Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), HMP Global (Editor-in-Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), Population Health Research Institute (clinical trial steering committee), Slack Publications (Chief Medical Editor, Cardiology Today’s Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees); other: Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair); research funding: Abbott, Amarin, Amgen, AstraZeneca, Bristol-Myers Squibb, Chiesi, Eisai, Ethicon, Forest Laboratories, Idorsia, Ironwood, Ischemix, Lilly, Medtronic, PhaseBio, Pfizer, Regeneron, Roche, Sanofi Aventis, Synaptic, The Medicines Company; royalties: Elsevier (Editor, Cardiovascular intervention: a companion to Braunwald’s heart disease); site co-investigator: Biotronik, Boston Scientific, St. Jude Medical (now Abbott), Svelte; trustee: American College of Cardiology; unfunded research: FlowCo, Merck, PLx Pharma, Takeda.

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