What were the greatest barriers to constructing feasible performance measures for PCI?
Our greatest barriers were the lack of definitive data on the risks and benefits of ad hoc PCI and multivessel PCI and their role in shared decision making by patients and providers. Additionally, creating an outcome measure to examine the incidence of dialysis after PCI was not included because the need for unexpected dialysis after PCI is extremely rare, and when dialysis does occur after PCI, it is often in patients with marginal renal function before the PCI for whom the possibility of dialysis was discussed previously.