The Quality of Quality: Is it Time for New Tools?
Over the past two decades, HMG-CoA reductase inhibitors ("statins") have taken center stage in the secondary prevention after MI as evidence of their efficacy emerged from clinical trials.1-4 Practice guidelines then incorporated the results of clinical trials and since guideline-based care processes were shown to be associated with outcomes,5 performance measures became an indicator of the quality of care.6 Performance measures track whether or not evidence-based medications are administered after MI. However, they do not assess whether or not the dose was optimal. The dose is an important issue for statins as their efficacy to prevent recurrent MI and death after the initial event has been shown to be greater at higher doses.2, 7
- Received January 31, 2014.
- Accepted January 31, 2014.