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Edward McNulty questions whether the registries analyzed in ASCERT (the STS Adult Cardiac Surgery Database and the ACCF NCDR) adequately capture the details that influence bedside clinical judgment and allow for truly effective comparisons. A study that he and his colleagues published last year of Kaiser patients undergoing nonemergent, unprotected left-main percutaneous coronary intervention (PCI) found that the majority of reasons cited for coronary artery bypass grafting (CABG) ineligibility were not captured by the NCDR. Dr. McNulty asks: Are NCDR data suitable for comparing outcomes after PCI versus CABG if important clinical factors are missing?
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