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2572], 'on': [153, 379, 1042, 1209, 1223, 1231, 1307, 1395, 1448, 1569, 1629, 1633, 2029, 2313, 2464, 2700, 2721, 2951, 3232], 'sustained': [155, 1024], 'basis': [156], 'are': [157, 228, 404, 884, 1072, 1242, 1608, 1732, 1806, 1965, 1997, 2093, 2199, 2216, 2640, 2745], 'themselves.The': [160], 'United': [161, 433, 3013, 3110, 3238], 'States': [162, 434, 3111, 3239], 'has': [163, 179, 222, 304, 307, 603, 633, 845, 1036, 1194, 1331, 1344, 1421, 1427, 1497, 1592, 2012, 2060, 2075], 'historically': [164], 'been': [165, 180, 308, 1195, 1345, 1371, 1422, 1498, 1593, 1717, 2013, 2062], 'leader': [167], 'training': [169, 386, 429, 456, 556, 588, 742, 769, 789, 819, 925, 1138, 1341, 2265, 2274, 2309, 2333, 2351, 3235], 'clinicians': [170], 'setting': [172], 'quality': [173, 1418, 1461, 1849, 2171, 2569, 2579, 2625, 2918], 'standards': [174, 2237], 'for': [175, 457, 481, 584, 597, 652, 662, 695, 737, 743, 787, 791, 811, 872, 1260, 1276, 1327, 1378, 1503, 1525, 1645, 1702, 1882, 1891, 1923, 1943, 1949, 2046, 2305, 2350, 2657, 2661, 2677, 2691, 2709, 2921, 2944, 3043, 3292, 3363], 'delivery.': [177], 'This': [178, 306, 373, 475, 731, 1581, 2338, 2513, 2725], 'especially': [181], 'evident': [182], 'field': [185, 221, 230, 344, 1035, 1589, 2659], 'interventional': [187, 322, 388, 427, 448, 460, 473, 499, 552, 653, 691, 758, 766, 808, 866, 994, 1084, 1090, 1159, 1438, 1565, 2230, 2290, 2488, 2611, 2682, 2783, 2800, 3151, 3233, 3364], 'cardiology,': [188, 629], 'relatively': [190, 1012], 'young': [191, 1013], 'subspecialty': [192, 257, 385, 623, 676, 1014, 2643, 2798], 'history': [195], 'robust': [197, 945, 1022, 1644, 2642], 'evolution': [198, 1025], 'expansion': [200, 293], 'since': [201], 'early': [203], 'days': [204], 'Andreas': [206], "Gruentzig's": [207], 'pioneering': [208], 'first': [209, 558, 622], 'coronary': [210, 279, 447, 500, 710, 1646, 1669, 1901, 2940, 3045, 3106, 3120], 'balloon': [211], 'angioplasty': [212], '1977.': [214], 'During': [215], 'past': [217, 290, 611, 645, 1044, 1203, 1884], '35': [218], 'years,': [219], 'rapidly': [223, 370, 992], 'relentlessly': [225], 'expanded.': [226], 'We': [227, 250, 325, 1964], 'started': [232], 'rather': [235, 1571, 2501], 'simple': [236], 'balloon-based': [237], 'revascularization': [238, 3107], 'concept': [239, 1193, 1298, 1335, 2317], 'applicable': [241], 'limited': [244, 2094], 'number': [245, 601, 631, 1856], 'carefully': [247], 'chosen': [248], 'patients.': [249], 'now': [252, 2139, 2200], 'evolved': [253], 'into': [254, 294, 2334, 2494], 'expansive': [256], 'treating': [258], 'wide': [260], 'range': [261, 1616], 'both': [263], 'stable': [264], 'acutely': [266], 'ill': [267], 'patients': [268, 1098], 'presenting': [269], 'broad': [272, 1615], 'spectrum': [273], 'not': [275, 1157, 1243, 1257, 1579, 1827, 1844, 2734, 2746], 'increasingly': [277, 1196, 1999], 'artery': [280], 'disease,': [281], 'but': [282, 1156], 'other': [284, 1055, 2576], 'cardiovascular': [285, 995, 1566, 2291], 'conditions.': [286], 'Notably,': [287], 'during': [288, 609, 643, 714, 720, 762, 911, 1041, 1201, 1666, 1914], 'decade,': [291], 'further': [292, 468], 'areas': [296, 829], 'peripheral': [298, 1166, 2327], 'vascular': [299, 1167, 2328], 'structural': [301, 1169, 2039, 2330], 'heart': [302, 1170, 2331, 3181], 'disease': [303, 2332], 'occurred.1': [305], 'accompanied': [309], 'by': [310, 523, 1347, 1445, 1466, 1563, 2108, 2128, 2147, 2187, 2241, 2446, 2633], 'proliferation': [312], 'voluminous': [315], 'amount': [316, 1252], 'scientific': [318], 'information': [319, 1969], 'facilitating': [320, 2379], 'our': [321, 343, 1011, 1034, 1039, 2129, 2195, 2225, 2242, 2547, 2658, 2662], "community's": [323], 'maturation.': [324], 'assumed': [327, 2632], 'leadership': [329, 2601], 'position': [330], 'practice': [333, 509, 772, 1040, 1163, 1277, 1995, 2140, 2189, 2239, 2549], 'evidence-based': [335, 2421], 'medicine.': [337], 'However,': [338, 1191, 1620, 1725, 2437], 'ever-emerging': [340], 'advances': [341], 'inevitably': [346], 'led': [347], 'us': [348], 'another': [350], 'critical': [351], 'challenge': [352], 'delivery': [356], 'patient': [358, 422, 862, 1281, 1951, 2553], 'care,': [359, 2196], 'which': [360, 519, 602, 1574], 'involves': [361, 1137], 'how': [362, 1093, 1396], 'best': [364, 1279], 'assure': [365, 1096, 2228], 'this': [369, 683, 936, 971, 1135, 1192, 1297, 1334, 1343, 1624, 1814, 2167, 2450, 2743], 'changing': [371, 993, 2780], 'scenario.': [372], 'viewpoint': [374], 'provides': [375], 'historical': [377], 'perspective': [378], 'certification': [381, 554, 571, 650, 661, 693, 729, 793, 812, 868, 882, 927, 940, 1368, 1414, 1454, 2071, 2429, 2433, 2679, 2817, 2914], 'process': [382, 1136, 2451], 'cardiology.': [389, 2683, 2801], 'In': [390, 797], 'addition,': [391], 'it': [392, 1533, 1822], 'highlights': [393], 'current': [395, 1668, 2296, 2525, 2548], 'future': [397, 1101, 2656], 'challenges': [398, 963, 1150, 1862], 'competency': [401, 858, 987, 1127, 1322, 1789, 1840, 2276, 2395, 2428, 2467, 2509, 2623], 'we': [403, 1095, 1121, 1805, 1938, 2198, 2639], 'currently': [405, 636, 2125, 2530], 'dealing': [406, 973], 'as': [408, 410, 660, 830, 941, 1122, 1128, 1154, 1425, 1464, 1500, 1508, 1522, 1695, 1713, 1770, 1834, 1957, 2001, 2015, 2078, 2174, 2294, 2326, 2698], 'well': [409], 'measures': [411, 1468], 'may': [413, 1779, 2112], 'be': [414, 851, 1642, 2044, 2113, 2185, 2212, 2359, 2439, 2453, 2492, 2499, 2559, 2614, 2631], 'considered': [415], 'enable': [417], 'care.Certification:': [423], 'Historical': [424], 'PerspectiveThe': [425], 'initial': [426, 539, 564, 648, 690, 792, 924, 1634], 'cardiology': [428, 451, 553, 654, 692, 767, 867, 1357, 3152, 3234, 3365], 'experience': [430, 485, 541, 1778], 'development': [437, 579, 2381], 'ad': [439], 'hoc': [440], 'unregulated': [441], 'programs': [442, 891, 2587], 'mostly': [443, 2061], 'located': [444], 'at': [445, 542, 744, 1047, 1575, 2411], '"high-volume"': [446], 'centers.': [449], 'General': [450], 'fellows': [452], 'could': [453, 2358], 'continue': [454, 1131, 2232, 2248], 'additional': [459, 2323], 'year': [461], 'acquiring': [466], 'refining': [469], 'catheterization': [471, 1504, 3190], 'laboratory-based': [472], 'skills.': [474, 2054], 'was': [476, 557, 573, 655, 735, 775], 'informal': [478], 'non-Accreditation': [479], 'Council': [480, 583, 1326, 2304], 'Graduate': [482, 585, 1328, 2306], 'Medical': [483, 586, 1329, 2307, 2832], 'Education-sanctioned': [484], 'no': [487, 1434, 1721, 1809], 'universally': [488], 'accepted': [489, 1836, 2594], 'educational': [490, 2245, 2393], 'guidelines': [491, 1996], 'or': [492, 717, 892, 1071, 1264, 1272, 1698, 2048, 2073, 2087, 2368, 2374, 2627], 'targets.': [493], 'Practicing': [494], 'cardiologists': [495, 1091, 1160, 2231], 'desiring': [496], 'develop': [498, 2367], 'would': [502, 1548, 2220, 2339, 2514], 'often': [503, 520, 534, 1376], 'temporarily': [504], 'take': [505, 727, 1392], 'leave': [506], 'from': [507, 778, 817, 922, 1470, 1649, 2403, 2946, 3112], 'enroll': [511], 'short-duration': [513], '(frequently': [514], 'several': [515, 889, 2024, 2217], 'months)': [516], 'tutorial': [517], 'experiences,': [518], 'were': [521, 533, 593, 1456, 1561, 1578], 'facilitated': [522, 1950], 'industry.': [524], 'On': [525], 'returning': [526], 'back': [527, 1188], 'practice,': [530], 'expert': [531], 'proctors': [532], 'engaged': [535], 'oversee': [537], 'procedural': [540, 732, 784, 801, 902, 1147, 1176, 1364, 1486, 1495, 1506, 1527, 1679, 1777, 1795, 1831, 2021, 2053, 2106, 2269, 2526, 2539, 2544], '"trainee\'s"': [544], 'home': [545], 'medical': [546, 843, 1030, 1056, 1185, 1218, 1254, 1293, 1618, 2007, 2244, 2255, 2336, 2448, 2887, 3155], 'institution.': [547], 'Formal,': [548], 'defined,': [549], 'measurable': [551, 1289, 1530], 'introduced': [559, 656], '1999,': [561], 'when': [562, 1735], 'American': [565, 2669, 2702, 2751, 2790, 2810, 3341, 3422], 'Board': [566, 2670, 2791, 2811], 'Internal': [568, 2672, 2793, 2795, 2813], 'Medicine': [569, 2673], '(ABIM)': [570], 'examination': [572, 651, 697, 2680, 2915], 'administered': [574], 'conjunction': [576], 'structured': [581], 'Accreditation': [582, 1325, 2303], 'Education-accredited': [587], 'programs.In': [589], '1936,': [590], '44': [591], 'candidates': [592, 627, 641, 687, 739, 810, 883, 1389], 'awarded': [594], 'ABIM': [595, 619, 649, 865, 1349], 'certificates': [596, 607, 624], 'internal': [598, 1450], 'medicine,': [599], 'grown': [604, 634], '7000': [606], 'annually': [608, 642], 'decade.': [612, 646, 1204], 'Five': [613], 'years': [614, 723, 914], 'later,': [615], '1941,': [617], 'issued': [620], '51': [626], '700': [637], '900': [639], 'certified': [640], '1999': [658, 779, 930], 'described': [659], '"Area': [664], 'Added': [666], 'Qualification"': [667], 'changed': [669, 1038], '2006': [671, 1918], 'designation': [674], 'board': [677, 1406], 'certification.': [678, 1407], 'vast': [680, 1251], 'majority': [681], 'group': [684, 937], '2115': [686], 'who': [688, 2111], 'received': [689], 'qualified': [694, 2635], 'through': [698], '"practice': [700], 'pathway"': [701, 752], 'requiring': [702, 876, 1172, 1388], 'candidate': [704], 'performed': [707, 761, 1665], 'either': [708, 1069, 2366, 2372], '500': [709], 'percutaneous': [711, 2938, 3044, 3119], 'interventions': [712, 1171, 3046], '(PCIs)': [713], 'lifetime': [716, 1776], '150': [718, 909], 'PCIs': [719, 910], '2': [722, 913, 1045], 'before': [724, 915], 'applying': [725, 2253], 'examination.': [730], 'volume': [733, 785, 802, 903, 1496, 1528, 1559, 1584, 1680, 1688, 1772, 1786, 1796, 1817, 1832, 2527, 2545, 2969, 3007], 'target': [734, 904], 'applied': [736, 2360], 'those': [738, 2736, 2748], 'out': [740], 'least': [745], '3': [746], 'years.': [747, 1190, 1888], 'more': [749, 1221, 1491, 1538, 1650, 1696, 2163, 2165, 2383], 'traditional': [750, 1206], '"training': [751], 'mandated': [753], 'minimum': [755, 907], '250': [757], 'cardiac': [759, 2040, 3189], 'procedures': [760, 1874, 1956, 1989, 2489, 3153], 'accredited': [764], '12-month': [765], 'fellowship': [768, 1340], 'program.': [770], 'pathway': [773, 790, 926], 'track': [774], 'available': [776], '2003;': [781], 'however,': [782], 'requirements': [786], 'remain': [794, 1761], 'unchanged': [795], 'today.': [796], 'addition': [798], 'meeting': [800], 'passing': [804], 'secure': [806, 896], 'examination,': [807, 898], 'fellow': [809, 2067], 'must': [813, 2390, 2452, 2468, 2558, 2617], 'present': [815, 1863, 2034], 'documentation': [816], 'program': [820], 'director': [821], 'attesting': [822], 'such': [828, 1694, 1712, 1769, 1954, 2173, 2293, 2325], 'practice-based': [831], 'learning': [832, 849, 890, 1233, 1317, 1521, 2316, 2386], 'improvement,': [834], 'interpersonal': [835], 'communication': [837, 1262], 'skills,': [838], 'professionalism,': [839], 'system-based': [841], 'practice.2The': [842], 'community': [844, 1125, 2246], 'always': [846], 'appreciated': [847, 2000], 'lifelong': [848, 1316, 2385], 'important': [853, 999, 1968, 2003], 'component': [854, 2004], 'maintaining': [856], 'excellent': [861], 'Accordingly,': [864], 'time-limited,': [870], 'valid': [871], '10-year': [874], 'period': [875], 'subsequent': [877], 'cyclic': [878], 'recertification.': [879], 'Maintenance': [880, 1366, 2815], 'participate': [887, 2621], 'modules,': [893, 2072], 'pass': [894], 'recertification': [897, 949], 'meet': [900, 2234], 'expiration': [916], 'certificate.': [919], 'Early': [920], 'data': [921, 1426, 1435, 1648, 1742, 1760, 1928, 2095, 2418], '2000': [932], 'show': [933], '>80%': [934], 'maintained': [938], '2012': [943, 2714, 3421, 3430], 'suggesting': [944, 1429, 1685, 2096], 'participation': [946], 'process.3The': [950], 'Landscape:': [952], 'Current': [953, 1980], 'ChallengesThe': [954], 'Rapid': [955], 'Evolution': [956], 'PracticeSimilar': [960], 'outlined': [964], 'previous': [967], 'focused': [968, 1222], 'editorial': [969], 'journal': [972], 'regulatory': [976, 2150, 2636, 2834], 'agencies': [977], 'oversight': [978], 'product': [980], 'efficacy': [981], 'safety,': [983], 'assuring': [984], 'keeps': [988], 'pace': [989, 1049], 'environment': [996, 1866, 2143], 'assignment': [1000], 'provide': [1002, 1459, 2598], 'services.4': [1005], 'constantly': [1007, 1391], 'evolving': [1008, 2392], 'nature': [1009], 'presents': [1015, 1488], 'landscape': [1017, 2169], 'challenges.': [1020], 'pharmacological': [1028], 'device': [1031, 2833], 'industry': [1032, 2074], 'dramatically': [1037], 'decades': [1046], 'complexity': [1051], 'unmatched': [1052], 'fields.': [1057], 'New': [1058], 'devices': [1059, 1066, 1130, 1144], '(eg,': [1060, 1067], 'transcatheter': [1061], 'valves)': [1062], 'emerge,': [1063], 'whereas': [1064], 'older': [1065], 'rotablator)': [1068], 'sunset': [1070], 'used': [1073, 1499, 2045, 2076, 2090, 2377], 'less': [1075, 1229, 1643, 1691, 2088, 2375, 2634], 'frequency': [1076], 'while': [1077], 'still': [1078], 'remaining': [1079], 'valuable': [1080], 'assets': [1081], "cardiologist's": [1085], 'toolbox.': [1086], 'As': [1087], 'earlier': [1088], 'generation': [1089], 'retire,': [1092], 'do': [1094, 1120, 1937], 'will': [1102, 2184, 2210, 2318, 2630], 'access': [1104, 1952, 2554], 'these': [1106, 1143, 1726, 1759, 1765, 2058, 2208, 2273, 2628, 2649, 2738], 'technologies': [1107, 2378], 'placed': [1108, 2463], 'hands': [1111], 'adequately': [1114], 'skilled': [1115], 'application?': [1118], 'How': [1119, 1936], 'address': [1126, 2283], 'new': [1129, 2086, 2168], 'emerge': [1133], 'appreciating': [1134], 'sufficient': [1140], 'exposure': [1141], 'maintain': [1146, 1273, 1321, 2369], 'skills?': [1148], 'These': [1149, 1861, 2496], 'become': [1151], 'increasing': [1152], 'all': [1158, 2207, 2302, 2487], 'expand': [1161], 'include': [1165], 'expanded': [1173], 'cognitive': [1174, 1362, 1443, 2051, 2104, 2267, 3145], 'skill': [1177], 'sets.Evolving': [1178], 'Educational': [1179], 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'competencies,': [1296], 'promotes': [1300], 'greater': [1301, 1700], '"learner': [1302], 'centeredness,"': [1303], 'responsibility': [1306, 2596], 'adjust': [1311], 'manage': [1313], 'own': [1315], 'achieve': [1319], 'milestones.5': [1323], 'Education': [1330, 2308], 'agreed': [1332], 'area': [1338, 2065, 2260], 'embraced': [1346], 'executing': [1351], 'charge': [1353], 'certify': [1355], 'competence.Interventional': [1356], 'requires': [1358], 'multiple': [1359], 'including': [1361, 1985, 2581], 'competencies.': [1365, 2270, 2354], 'examinations': [1369, 1393, 1455, 2398], 'met': [1372], 'mixed': [1374], 'emotions,': [1375], 'criticized': [1377], 'being': [1379, 2126], 'tedious,': [1380], 'irrelevant,': [1381], 'costly,': [1382], 'inconvenient': [1384], 'creating': [1385], 'system': [1387], 'depending': [1394, 1628], 'specialties': [1398], 'subspecialties': [1400], 'they': [1401], 'wish': [1402], 'retain': [1404, 1551], 'association': [1409, 1625, 1674], 'between': [1410, 1675, 2538, 2911], 'maintenance': [1412, 1452, 1484, 2069, 2431, 2912], '(examination': [1415], 'scores)': [1416], 'interest': [1424], 'emerged': [1428], 'positive': [1431, 1657, 1682], 'exist': [1436], 'regarding': [1437, 1970], 'cardiologists,': [1439], 'internists': [1440], 'demonstrating': [1441], 'higher': [1442, 1676], 'performing': [1446], 'better': [1447, 1460, 1544, 1554, 1611, 1754, 2534], 'medicine': [1451, 1591, 2422, 2796], 'found': [1457], 'evaluated': [1465], 'outcome': [1467, 1586, 2511, 2972], 'derived': [1469], 'analysis': [1472], 'large': [1475, 1652, 1737], 'Medicare': [1476, 1905, 2922], 'database.6Procedural': [1477], 'Competence:': [1478], 'Volume': [1480, 3075], 'QuestionThe': [1481], 'evaluation': [1482, 2049, 3147], 'even': [1490], 'challenging': [1492], 'issue.': [1493], 'Historically,': [1494], 'surrogate': [1502, 1524], 'laboratory': [1505], 'performance': [1507, 2118, 2161, 2176, 2183, 2472, 2573, 3149], 'one': [1509, 1539, 2564], 'benchmarks': [1512, 1560, 2518], 'certifying': [1515], 'competence.': [1516, 2022], 'Similar': [1517], 'using': [1519, 1828, 2423, 2516, 3154], 'competence,': [1526], 'intuitively': [1532], 'appears': [1534, 1640], 'reasonable': [1535, 1855, 2481], 'performs': [1540], 'procedure,': [1542], 'operator': [1547, 1677, 1785, 1879], 'attain': [1549], 'resulting': [1552], 'outcomes.': [1556, 1979], 'original': [1558], 'set': [1562, 2483], 'experienced': [1564], 'experts': [1567], 'based': [1568], 'judgment': [1570], 'than': [1572, 2502], 'data,': [1573], 'time': [1577, 1919, 2348, 2461], 'available.7': [1580], 'relationship': [1582, 1639, 2537], 'subject': [1595], 'much': [1597], 'investigation': [1598, 1635], 'discussion.': [1600], 'Overall,': [1601], 'high': [1602, 1605, 2236], 'hospital': [1603, 2578], 'volumes': [1607, 1880, 1912], 'associated': [1609], 'across': [1613], 'procedures.': [1619], 'magnitude': [1622], 'varies': [1626], 'widely': [1627], 'procedure.': [1631], 'volume–outcome': [1638], 'angioplasty,': [1647], 'recent': [1651, 3116], 'registries': [1653], 'suggest': [1654], 'correlation': [1658, 1787, 1797, 1972], 'does': [1659], 'fact': [1661], 'exist.8,9': [1662], 'Most': [1663], 'studies': [1664, 1727], 'stent': [1670, 3049], 'era': [1671], 'support': [1672], 'PCI': [1678, 1873, 1934, 1959], 'results': [1684], 'lower': [1687, 1815, 1877], 'operators': [1689, 1976], 'favorable': [1692], 'bleeding': [1697], 'need': [1701, 1948], 'surgical': [1703, 3009], 'revascularization.': [1704], 'Softer': [1705], 'correlations': [1706], 'involving': [1707, 2602], 'harder': [1708], 'end': [1710], 'points': [1711], 'in-hospital': [1714], 'mortality': [1715, 3010], 'inconsistently': [1718], 'reported': [1719, 1869], 'clear': [1722, 1810], 'guiding': [1723], 'signal.10,11': [1724], 'problems': [1730], 'frequently': [1733, 2089, 2376], 'encountered': [1734], 'analyzing': [1736], 'retrospective,': [1738], 'administrative': [1739], 'registries.': [1740, 2495], 'Incomplete': [1741], 'capture,': [1743], 'auditing': [1744], 'reporting,': [1746], 'inability': [1749], 'appropriately': [1751], 'risk-adjust': [1752], 'understand': [1755, 2535], 'implications': [1757], 'significant': [1762], 'limitations': [1763], 'analyses.': [1766], 'Other': [1767], 'confounders': [1768], 'institutional': [1771], "operator's": [1775], 'influence': [1781], 'annual': [1783], 'individual': [1784, 1878], 'outcomes.Accepting': [1791], 'low': [1794, 1961], 'adverse': [1799], 'might': [1802, 1819, 2098], 'indeed': [1803], 'exist,': [1804], 'provided': [1807], 'signal': [1811], 'defining': [1812], 'what': [1813], 'quantitative': [1816], 'threshold': [1818], 'be.': [1820], 'Intuitively': [1821], 'difficult': [1824], 'justify': [1826], 'minimal': [1830, 2297], 'benchmark': [1833], 'standard.': [1841], 'It': [1842, 2479], 'possible': [1845], 'adequate': [1848], 'assessment': [1850], 'without': [1853, 2352], 'cases': [1858, 2041], 'assess.': [1860], 'overall': [1870, 1931], 'decrease': [1871, 1899], 'accordingly': [1876], 'noted': [1881, 1913], '6': [1885], '7': [1887], 'Agency': [1890], 'Research': [1893], 'Quality': [1895], 'reports': [1896, 2162], '20%': [1898], 'stenting': [1902], 'population': [1906, 1962], '2010': [1908], 'compared': [1909], 'peak': [1911], '2004': [1916], 'period.12': [1920], 'Centers': [1922], 'Disease': [1924], 'Control': [1925], 'Prevention': [1927], 'reflect': [1929, 2391], 'similar': [1930], 'decreasing': [1932], 'inpatient': [1933], 'volumes.': [1935], 'balance': [1939], 'demand': [1942], 'life-saving': [1955], 'primary': [1958], 'areas?': [1963], 'lacking': [1967], 'very': [1974, 2114], 'high-volume': [1975], 'economic': [1983], 'concerns': [1984], 'appropriateness': [1987, 2193], 'compliance': [1991], 'suggested': [1993], 'becoming': [1998], 'competent': [2006], 'care.The': [2008], 'use': [2009, 2056, 2085, 2121], 'simulation': [2011, 2025, 2097, 2123], 'proposed': [2014], 'potential': [2017, 2120, 2342], 'tool': [2018, 2080], 'assess': [2020, 2103], 'Currently': [2023], 'companies': [2026], 'products': [2028], 'market': [2031], 'designed': [2032], 'coronary,': [2035], 'peripheral,': [2036], 'carotid,': [2037], 'can': [2043], 'simulators': [2059], 'education,': [2068], 'them': [2077], 'train': [2082], 'practitioners': [2083], 'devices.': [2091], 'There': [2092], 'offer': [2099, 2340], 'method': [2101], 'identifying': [2109], 'performers.13': [2116], 're-evaluated': [2127], 'professional': [2130, 2590], 'societies': [2131, 2591], 'ABIM.A': [2134], 'Glimpse': [2135], 'Into': [2136], 'FutureWe': [2138], 'increased': [2145], 'scrutiny': [2146], 'patients,': [2148], 'payers,': [2149], 'agencies,': [2151], 'media.': [2153], 'Benchmarks,': [2154], 'scorecards,': [2155], 'easily': [2157], 'accessible,': [2158], 'publically': [2159], 'displayed': [2160], 'dominate': [2166], 'bringing': [2170], 'issues': [2172, 2606], 'center': [2180], 'stage.': [2181], 'Our': [2182], 'judged': [2186], 'expected': [2201], 'render': [2203], 'because': [2206], 'metrics': [2209], 'eventually': [2211], 'tied': [2213], 'reimbursement.There': [2215], 'strategies': [2218], 'facilitate': [2221, 2319, 2508], 'moving': [2222], 'forward': [2223, 2252], 'efforts': [2226], 'patients.The': [2243], 'should': [2247, 2498], 'aggressively': [2250], 'push': [2251], 'concepts': [2257, 2277, 2357], 'Application': [2271], 'offers': [2278], 'real': [2279], 'opportunities': [2280], 'favorably': [2282], 'perceived': [2287], 'weakness': [2288], '7-year': [2298], 'requirement': [2299], 'obligations.': [2310], 'Less': [2311], 'dependency': [2312], 'incorporation': [2321], 'curriculum.': [2337], 'ease': [2344], 'burden': [2346], 'sacrificing': [2353], 'same': [2356], 'practicing': [2362, 2420, 2465, 2610], 'wanting': [2364], 'emerging': [2373], 'formal': [2384], 'evaluative': [2388], 'process.Certification': [2389], 'mandates.': [2396], 'Certification': [2397], 'already': [2400], 'moved': [2401], 'away': [2402], 'predominantly': [2404], 'testing': [2405], 'strategy': [2409], 'aimed': [2410], 'evaluating': [2412], "candidate's": [2414], 'synthesizing': [2417], 'good': [2424], 'Requiring': [2427], 'vitally': [2435], 'important.': [2436], 'effective': [2441], 'complete': [2444], '"buy-in"': [2445], 'community,': [2449], 'organized': [2454], 'sensitivity': [2456], 'financial': [2459], 'constraints': [2462], 'physicians.Evaluating': [2466], 'imply': [2469], 'recording': [2470], 'uniform': [2475], 'entered': [2493], 'databases': [2497], 'administrative,': [2503], 'enabling': [2504], 'risk': [2505], 'adjustment': [2506], 'assessments.': [2512], 'involve': [2515], 'standardized': [2517], 'reporting': [2520], 'metrics.': [2521], 'reassessment': [2523], 'targets': [2528], 'underway': [2531], 'attempting': [2532], 'environment.': [2550], 'Sensitivities': [2551], 'considered.Physician': [2560], 'just': [2563], 'assurance.': [2570], 'Coordinating': [2571], 'initiatives': [2574, 2580, 2626], 'complementary': [2577], 'organizing': [2582], 'local': [2583], 'monitoring': [2584], 'corrective': [2586], 'essential.Our': [2589], 'proactively': [2593], 'direction': [2599], 'discussed': [2607], 'here.': [2608], 'cardiologist': [2612], 'cannot': [2613], 'passive': [2615], 'actively': [2618], 'responsibilities': [2629], 'groups.': [2637], 'Fortunately,': [2638], 'tradition': [2646], 'overcoming': [2648], 'types': [2650], 'challenges,': [2652], 'promising': [2653], 'bright': [2655], 'patients.DisclosuresDr': [2663], 'Chair': [2666], 'question': [2674], 'writing': [2675], 'committee': [2676], 'He': [2684], 'President-Elect': [2687], 'Society': [2690, 3402], 'Cardiac': [2692, 2722], 'Angiography': [2693, 2711], 'Interventions': [2695, 2713], 'serves': [2697], 'Vice-Chair': [2699], 'Foundation/American': [2706], 'Heart': [2707, 2752, 3423], 'Association/Society': [2708], 'Update': [2715], 'Clinical': [2718, 2935, 2952], 'Competence': [2719], 'Statement': [2720], 'Procedures.': [2724], 'article': [2726, 2744], 'reflects': [2727], 'opinions': [2729, 2740], 'author': 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