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The appropriateness use criteria (AUC) report from the American College of Cardiology Foundation provides a framework for use of coronary revascularization. We evaluated the use of these AUC by interventional cardiologists (IC) in real world practice.
The study was performed over a 10 month period. Four IC from a large healthcare center participated in the study. Every month, one IC independently reviewed randomly assigned cases of other ICs and assigned them to Appropriate (A), Inappropriate (I) and Uncertain (U) categories as per the AUC document. All cases were discussed in a monthly meeting. The primary operating IC could either agree or disagree (provide written reasons for disagreement) with the reviewing IC assessment.
A total of 114 patient records were reviewed. Eighty patients were assigned to appropriate, 11 patients to inappropriate and 19 patients were assigned to uncertain categories. Four patients could not be assigned to any category. Out of 30 patients assigned to either I or U categories, there was disagreement between the reviewing and operating ICs regarding 23 patients (3 patients – Revascularization for ACS; 20 patients – Revascularization for non-ACS)
There is variability and disagreement in the interpretation of inappropriate and uncertain AUC, especially for non-ACS scenarios. Inclusion of additional patient scenarios and further clarification of the existing scenarios may decrease the variability in interpretation.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: PCI: Outcomes, Adherence and Appropriateness
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1288-100
- 2013 American College of Cardiology Foundation