{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T23:01:10Z","timestamp":1763766070551},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>We asked whether visits to physician offices and hospital outpatient clinics for angina have changed over time and whether more frequent use of certain diagnostic techniques or referrals in this setting may account for such changes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We combined data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to study visits to physician offices and outpatient departments. We calculated both crude and standardized rates for these visits using a modified version of technical specifications published by the Agency for Healthcare Research and Quality. In 1995 to 1998, there were on average 3.6 million office\/clinic visits each year for angina among adults in the United States. By 2007 to 2010, this had declined to 2.3 million visits each year. Angina visit rates per 100 000 declined significantly (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05), with the greatest decline from 1995 through 1998 to 2003 through 2007. Coronary atherosclerotic disease diagnoses also declined after 2002. Both stress testing and referring patients out for care doubled during some study periods.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>\n              Office and clinic visits for angina have declined over time. This trend parallels findings for both preventable hospitalization and emergency room visits for angina. Previous research\u2019s decline in angina hospitalizations is not likely attributable to decreased referrals to hospital and emergency rooms for diagnosis and management. Although changes in\n              <jats:italic>International Classification of Diseases, Ninth Revision, Clinical Modification<\/jats:italic>\n              coding guidelines may explain some of the decline in angina and coronary atherosclerotic disease visits, it seems that other factors such as improved treatment or prevention may have played an additional role.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.113.000450","type":"journal-article","created":{"date-parts":[[2014,1,15]],"date-time":"2014-01-15T06:43:42Z","timestamp":1389768222000},"page":"110-117","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["National Trends in Visits to Physician Offices and Outpatient Clinics for Angina 1995 to 2010"],"prefix":"10.1161","volume":"7","author":[{"given":"Julie C.","family":"Will","sequence":"first","affiliation":[{"name":"From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fleetwood","family":"Loustalot","sequence":"additional","affiliation":[{"name":"From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuling","family":"Hong","sequence":"additional","affiliation":[{"name":"From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","volume-title":"Guide to Prevention Quality Indicators: Hospital Admission for Ambulatory Care Sensitive Conditions. AHRQ Publication No. 02-R0203","author":"Department of Health and Human Services, Agency for Healthcare Research and Quality","year":"2007","unstructured":"Department of Health and Human Services, Agency for Healthcare Research and Quality. Guide to Prevention Quality Indicators: Hospital Admission for Ambulatory Care Sensitive Conditions. AHRQ Publication No. 02-R0203. Rockville, MD: Agency for Health Care Research and Quality;2007. http:\/\/www.qualityindicators.ahrq.gov\/Downloads\/Modules\/PQI\/V31\/pqi_guide_v31.pdf. Accessed January 31, 2013."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.174516"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31819e1f53"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.3.447"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.10.040"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd10.120322"},{"key":"e_1_3_2_8_2","volume-title":"Prevention Quality Indicators Technical Specifications, PQ#13 Angina Without Procedure Admission Rate. Version 4.1","author":"Agency for Health Care Research and Quality","year":"2009","unstructured":"Agency for Health Care Research and Quality. Prevention Quality Indicators Technical Specifications, PQ#13 Angina Without Procedure Admission Rate. Version 4.1. Rockville, MD: Agency for Health Care Research and Quality;2009. http:\/\/www.qualityindicators.ahrq.gov. Accessed November 19, 2012."},{"key":"e_1_3_2_9_2","author":"US Department of Health and Human Services, Centers for Disease Control and Prevention.","year":"2013","unstructured":"US Department of Health and Human Services, Centers for Disease Control and Prevention. National Ambulatory Medical Care Survey Questionnaires, Datasets, and Related Documents. 2013. http:\/\/www.cdc.gov\/nchs\/ahcd\/ahcd_questionnaires.htm. Accessed March 21, 2013.","journal-title":"National Ambulatory Medical Care Survey Questionnaires, Datasets, and Related Documents"},{"key":"e_1_3_2_10_2","author":"US Department of Health and Human Services, Centers for Disease Control and Prevention","year":"2012","unstructured":"US Department of Health and Human Services, Centers for Disease Control and Prevention. National Hospital Ambulatory Medical Care Survey Questionnaires, Datasets, and Related Documents. 2012. http:\/\/www.cdc.gov\/nchs\/ahcd\/ahcd_questionnaires.htm. Accessed March 21, 2013.","journal-title":"National Hospital Ambulatory Medical Care Survey Questionnaires, Datasets, and Related Documents"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-007-0256-6"},{"key":"e_1_3_2_12_2","volume-title":"Census 2000 Brief Series","author":"US Census Bureau","year":"2000","unstructured":"US Census Bureau. Census 2000 Brief Series. Washington, DC: US Census Bureau;2000. http:\/\/www.census.gov\/population\/www\/cen2000\/briefs.html. Accessed November 19, 2012."},{"key":"e_1_3_2_13_2","volume-title":"SUDAAN (release 10.0) Language Manual","author":"Research Triangle Institute","year":"2008","unstructured":"Research Triangle Institute. SUDAAN (release 10.0) Language Manual. Research Triangle Park (NC): Research Triangle Institute;2008. http:\/\/www.rti.org\/sudaan. Accessed September 18, 2012."},{"key":"e_1_3_2_14_2","author":"US Preventive Services Task Force","year":"2012","unstructured":"US Preventive Services Task Force. Screening for Coronary Heart Disease With Electrocardiography: Clinical Summary of USPSTF Recommendation. AHRQ Publication No. 11-05158-EF-3. July 2012. http:\/\/www.uspreventiveservicestaskforce.org\/uspstf11\/coronarydis\/chdsum.htm. Accessed April 23, 2013.","journal-title":"Screening for Coronary Heart Disease With Electrocardiography: Clinical Summary of USPSTF Recommendation. AHRQ Publication No. 11-05158-EF-3"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2009.0560"},{"key":"e_1_3_2_16_2","first-page":"85","article-title":"Changes in prevalence of nonfatal coronary heart disease in the United States from 1971-1994.","volume":"13","author":"Ford ES","year":"2003","unstructured":"Ford ES, Giles WH. Changes in prevalence of nonfatal coronary heart disease in the United States from 1971-1994. Ethn Dis. 2003;13:85\u201393.","journal-title":"Ethn Dis"},{"key":"e_1_3_2_17_2","first-page":"42","article-title":"Self-administration of a questionnaire on chest pain and intermittent claudication.","volume":"31","author":"Rose G","year":"1977","unstructured":"Rose G, McCartney P, Reid DD. Self-administration of a questionnaire on chest pain and intermittent claudication. Br J Prev Soc Med. 1977;31:42\u201348.","journal-title":"Br J Prev Soc Med"},{"key":"e_1_3_2_18_2","volume-title":"Trends in High LDL Cholesterol, Cholesterol-Lowering Medication Use, and Dietary Saturated-Fat Intake: United States, 1976\u20132010. NCHS Data Brief No. 117","author":"Kuklina EV","year":"2013","unstructured":"Kuklina EV, Carroll MD, Shaw KM, Hirsch R. Trends in High LDL Cholesterol, Cholesterol-Lowering Medication Use, and Dietary Saturated-Fat Intake: United States, 1976\u20132010. NCHS Data Brief No. 117. Hyattsville, MD: National Center for Health Statistics;2013."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.057885"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa0805646"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.650"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.962456"},{"key":"e_1_3_2_23_2","author":"Primaris","unstructured":"Primaris. DRG 140. ICD-9 CM Coding Guidelines. http:\/\/www.primaris.org\/sites\/default\/files\/resources\/HPMP\/coding%20guidelines%20booklet_DRG_140.pdf. Accessed April 5, 2013.","journal-title":"DRG 140. ICD-9 CM Coding Guidelines"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.560433"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67394-1"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.187930"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050461"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.020"}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.113.000450","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:39:38Z","timestamp":1715567978000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.113.000450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,1]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.113.000450"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.113.000450","relation":{},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1]]},"assertion":[{"value":"2013-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-11-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-01-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}