PHYSICIANS JUDGMENTS OF THE RISKS OF CARDIAC PROCEDURES - DIFFERENCESBETWEEN CARDIOLOGISTS AND OTHER INTERNISTS

OBJECTIVES. The authors compared judgments of the population risks of invasive cardiac procedures made by cardiologists and other internal m edicine physicians. Our main hypotheses were that cardiologists' judgm ents would differ from those made by the other physicians and that car diologists' judgments would be more accurate than those of other physi cians. METHODS. This was a cross-sectional survey of senior staff and physician-trainees at two teaching hospitals affiliated with a US medi cal school, Emergency Department physicians at a community hospital in the same metropolitan area, and senior staff and trainees at two teac hing hospitals affiliated with a UK school. Judgments of the risks of severe morbidity and death due to Swan-Ganz catheterization, cardiac c atheterization, percutaneous coronary angioplasty, and coronary artery bypass grafting were assessed. RESULTS. Nineteen cardiologists judged the risks of severe morbidity due to all procedures and the risks of death due to all procedures except coronary artery bypass grafting to be significantly lower than did the 78 other internists. Cardiologists more frequently made accurate judgments of the rates of morbidity and death due to cardiac catheterization than did the other internists; o ther internists more frequently made accurate judgments far the rates of morbidity due to Swan-Ganz catheterization. CONCLUSIONS. Disagreeme nts about the risks of procedures may arise from a paucity of publishe d data, or from an over-supply of confusing data.