Appropriate use criteria (AUC), sometimes referred to as appropriateness criteria (AC), specify when it is appropriate to perform a medical procedure or service. An "appropriate" procedure is one for which the expected health benefits exceed the expected health risks by a wide margin. Ideally, AUC are evidence-based, but in the absence of sufficient evidence, may be derived from a consensus of expert opinion. AUC are typically classified in terms of the quality of the evidence on which they are based. In general, AUC are promulgated by medical specialty organizations (professional societies). The definition of "appropriate" is subject to interpretation. For example, a key issue is whether or not a procedure or investigation can be deemed appropriate if it does not result in a change in management.
Relative costs of alternative appropriate procedures may or may not be considered in selecting a procedure for an individual patient, but in there is evidence that performing only appropriate procedures reduces volume and cost. To reduce the cost of (advanced) diagnostic imaging tests, a requirement for the use of clinical decision support for was included in the
Protecting Access to Medicare Act of 2014
The Protecting Access to Medicare Act of 2014 (; ) is a law that delayed until March 2015 a pending cut to Medicare physician payment, a cut that had been regularly delayed for over a decade. Because the law only delayed and did not repeal the ph ...
, though it does not apply to emergency or inpatient services.
AUC are not always consistent between sources, or with other guidelines, or with reimbursement decisions. Additionally, AUC have not shown an impact in physician's behaviour.
AUC may be promulgated in human-readable form, or converted into an electronic structured form for use in a
clinical decision support system
A clinical decision support system (CDSS) is a health information technology, provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, to help health and health care. CDSS encompasses a variety of ...
, such as a
computerized physician order entry
Computerized physician order entry (CPOE), sometimes referred to as computerized provider order entry or computerized provider order management (CPOM), is a process of electronic entry of medical practitioner instructions for the treatment of pat ...
system.
References
External links
American Academy of Dermatology (AAD) - Appropriate use criteriaAmerican Academy of Orthopaedic Surgeons (AAOS) - What Are Appropriate Use Criteria?American College of Cardiology Foundation (ACCF) Appropriate Use CriteriaAmerican College of Radiology (ACR) - About the ACR Appropriateness CriteriaAmerican Society of Echocardiography (ASE) - Appropriate Use CriteriaInternational Spine Intervention Society (ISIS) - Appropriate Use CriteriaNorth American Spine Society (NASS) - Appropriate Use CriteriaSociety of Nuclear Medicine and Molecular Imaging (SNMMI) - Appropriate Use Criteria
Practice of medicine
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