The Medicare Appropriate Use Criteria Program: A Review of Recommendations for Testing in Coronary Artery Disease.
Ann Intern Med
; 176(9): 1235-1239, 2023 09.
Article
em En
| MEDLINE
| ID: mdl-37603865
ABSTRACT
BACKGROUND:
Congress established the Appropriate Use Criteria (AUC) Program to reduce unnecessary advanced imaging studies. Organizations that wish to develop AUC can apply to the Centers for Medicare & Medicaid Services (CMS) to qualify as provider-led entities (PLEs) under this program. Variable methods, content, and formatting of PLE-generated AUC could lead to clinician uncertainty about whether an advanced imaging test is appropriate or not.PURPOSE:
To review AUC published by CMS-qualified PLEs focused on advanced imaging tests for coronary artery disease (CAD), a "priority clinical area" identified by CMS. DATA SOURCES Publicly available data from the worldwide web searched on 29 August 2022. STUDY SELECTION Approved AUC with recommendations related to testing for CAD. DATA EXTRACTION Manual review of published AUC by all authors. DATASYNTHESIS:
Among the 17 CMS-qualified PLEs, only 7 had published AUC related to CAD. Substantial variation in the methods and formatting of these AUCs was observed. The number of clinical scenarios covered ranged from 6 to 210, and the number of advanced imaging methods covered ranged from 1 to 25. When specifically applied to clinical scenarios, many AUC offered no guidance on appropriateness; those that did conflicted with respect to appropriateness.LIMITATION:
Other CMS-identified priority clinical areas were not evaluated.CONCLUSION:
CMS-qualified AUC for imaging of CAD are heterogeneous and sometimes discrepant, creating substantial potential for uncertainty among clinicians seeking to provide their patients with appropriate imaging tests. PRIMARY FUNDING SOURCE No funding was received for this study.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limite:
Aged
/
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article