scholarly journals Appropriate Use Criteria ( AUC ) for Ancillary Diagnostic Testing in Dermatopathology: New Recommendations for 11 tests and 220 clinical scenarios from the American Society of Dermatopathology AUC Committee

2021 ◽  
Author(s):  
Maxwell A. Fung ◽  
Claudia I. Vidal ◽  
Eric A. Armbrecht ◽  
Aleodor A. Andea ◽  
David S. Cassarino ◽  
...  
Keyword(s):  
Diagnostic Testing ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Clinical Scenarios ◽  
American Society

scholarly journals Appropriate Use Criteria and the Imaging Mandate

2017 ◽  
pp. 1
Author(s):  
Gregory J Dehmer ◽  
Leah White ◽  
John U Doherty ◽  
◽  
◽  
...  
Keyword(s):  
Imaging Modality ◽  
Clinical Care ◽  
Cost Savings ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Testing Procedures ◽  
Multiple Imaging ◽  
Clinical Scenarios ◽  
Unnecessary Procedures

Appropriate use criteria (AUC) have existed for over 30 years and are being deployed with increasing frequency to study the delivery of healthcare. The goal of AUC is to advise all stakeholders about the reasonable use of testing procedures or therapies to improve symptoms, quality of life, and health outcomes. Numerous studies have shown the favorable effects of AUC to limit the overuse of unnecessary procedures while also promoting high-quality clinical care and cost savings. AUC evaluating only a single imaging modality have been replaced by multimodality documents, making it easier for the clinician to evaluate the appropriateness of multiple imaging methods in various clinical scenarios. The Protecting Access to Medicare Act of 2014 contained language mandating the use of AUC when ordering certain advanced cardiac imaging tests, and this requirement is currently scheduled for implementation in January 2020. Clinicians need to be aware of the increasing use of AUC and the financial implications of the AUC mandate legislation.

scholarly journals Appropriate Use of Transesophageal Echocardiogram for Infective Endocarditis: A Single Center Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Robby Singh ◽  
Moumita Naidu ◽  
Yousef Bader ◽  
David Freeman ◽  
Marcel Zughaib
Keyword(s):  
Infective Endocarditis ◽  
Transesophageal Echocardiography ◽  
Ease Of Use ◽  
High Yield ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Transesophageal Echocardiogram ◽  
Cardiac Device ◽  
Duke Criteria ◽  
American Society

Background. Transesophageal echocardiogram (TEE) is a valuable tool in healthcare today with its ease of use, ability to visualize important structures not seen on transthoracic echocardiogram (TTE), and the relatively lower cost of TEE, high yield, and no significant radiation exposure. The American Society of Echocardiography (ASE) has developed an appropriate use criteria for use of TTE and TEE, which outline various scenarios where a TEE is indicated as an initial diagnostic testing modality and when it is useful as an adjunctive test in hopes of decreasing inappropriate use. Using these criteria as a guide, we devised a quality assessment study to investigate how well TEEs performed at our institution fit the appropriate use criteria specifically for the diagnostic workup of infective endocarditis. Methods. A retrospective chart review was performed for all TEEs performed in 2017 with the indication of endocarditis. Baseline patient characteristics, presence of bacteremia, and the quality of the TTE preceding the TEE were noted, as well as whether a vegetation, abscess, or perforation was visualized. We also determined if there was a cardiology consultation placed prior to TEE and if the patient had met the definition for endocarditis as defined by the Duke criteria. Finally, we made note of the TEE findings and assessed whether the TEE met appropriate use criteria developed by the American Society of Echocardiography. Results. A total of 50 patients who underwent TEE with the indication of “endocarditis” were identified. 36% of the TTEs prior to the TEE were rated as good quality, 40% as adequate, 4% as fair, 4% as suboptimal, 12% as technically difficult, and 4% were not rated. Vegetations were visualized on 12% of TTEs, 6% of patients had a prosthetic valve, and 6% had a cardiac device. In 20% of the cases, there was no cardiology consultation prior to the TEE and in 20% of the cases, there was no documented bacteremia. 26% of patients met the Duke criteria for endocarditis prior to TEE. Only 36% of TEEs revealed evidence of infection and of the patients with no evidence of infection, only 38% met appropriate use criteria. Overall, only 56% of patients met appropriate use criteria for TEE. Conclusion. Transesophageal echocardiography is a valuable tool in a modern physician’s arsenal for managing a variety of diseases and conditions. However, the procedure is not without associated risks and its ease of use and widespread adoption has led to frequent questionable appropriateness of use of the test. Only 56% of the TEEs performed in our analysis met appropriate use. More awareness and education is needed for the appropriate use criteria for transesophageal echocardiography as outlined by the ASE to help reduce patient exposure to procedure related complications and to decrease medical costs on unnecessary procedures.

scholarly journals Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology

2019 ◽  
Vol 80 (1) ◽  
pp. 189-207.e11 ◽  
Author(s):  
Claudia I. Vidal ◽  
Eric A. Armbrect ◽  
Aleodor A. Andea ◽  
Angela K. Bohlke ◽  
Nneka I. Comfere ◽  
...  
Keyword(s):  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
American Society

scholarly journals Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology

2018 ◽  
Vol 45 (8) ◽  
pp. 563-580 ◽  
Author(s):  
Claudia I. Vidal ◽  
Eric A. Armbrect ◽  
Aleodor A. Andea ◽  
Angela K. Bohlke ◽  
Nneka I. Comfere ◽  
...  
Keyword(s):  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
American Society
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