Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology - 13/12/18
Task Force/Committee Members
Claudia I. Vidal, MD, PhD a, ⁎ , Eric A. Armbrect, PhD b, Aleodor A. Andea, MD c, Angela K. Bohlke, MD, PhD d, Nneka I. Comfere, MD e, Sarah R. Hughes, MD f, Jinah Kim, MD, PhD g, Jessica A. Kozel, MD h, Jason B. Lee, MD i, Konstantinos Linos, MD j, Brandon R. Litzner, MD k, l, Tricia A. Missall, MD, PhD a, Roberto A. Novoa, MD g, Uma Sundram, MD, PhD m, Brian L. Swick, MD n, M. Yadira Hurley, MD a : Chair,Rating Panel
Murad Alam, MD, MSCI, MBA o, Zsolt Argenyi, MD p, Lyn M. Duncan, MD q, Dirk M. Elston, MD r, Patrick O. Emanuel, MBChB s, Tammie Ferringer, MD t, Maxwell A. Fung, MD u, Gregory A. Hosler, MD, PhD v, Alexander J. Lazar, MD, PhD w, Lori Lowe, MD c, Jose A. Plaza, MD x, Victor G. Prieto, MD, PhD w, June K. Robinson, MD y, Andras Schaffer, MD, PhD z, Antonio Subtil, MD, MBA aa, Wei-Lien Wang, MD bbAbstract |
Background |
Appropriate use criteria (AUC) provide physicians guidance in test selection, and can affect health care delivery, reimbursement policy, and physician decision-making.
Objectives |
The American Society of Dermatopathology, with input from the American Academy of Dermatology and the College of American Pathologists, sought to develop AUC in dermatopathology.
Methods |
The RAND/UCLA appropriateness methodology, which combines evidence-based medicine, clinical experience, and expert judgment, was used to develop AUC in dermatopathology.
Results |
With the number of ratings predetermined at 3, AUC were developed for 211 clinical scenarios involving 12 ancillary studies. Consensus was reached for 188 (89%) clinical scenarios, with 93 (44%) considered “usually appropriate” and 52 (25%) “rarely appropriate” and 43 (20%) having “uncertain appropriateness.”
Limitations |
The methodology requires a focus on appropriateness without comparison between tests and irrespective of cost.
Conclusions |
The ultimate decision to order specific tests rests with the physician and is one where the expected benefit exceeds the negative consequences. This publication outlines the recommendations of appropriateness—the AUC for 12 tests used in dermatopathology. Importantly, these recommendations may change considering new evidence. Results deemed “uncertain appropriateness” and where consensus was not reached may benefit from further research.
Le texte complet de cet article est disponible en PDF.Key words : ancillary studies, appropriate use criteria, dermatopathology, evidence-based medicine, expert rating
Abbreviations used : ASDP, AUC, UQ
Plan
With permission from Vidal CI, Armbrect EA, Andea AA, et al. Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology, Journal of Cutaneous Pathology, Volume 45, pages 563-580, John Wiley & Sons A/S, 2018. |
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Drs Vidal, Armbrect, Andea, Bohlke, Comfere, Hughes, Kim, Kozel, Lee, Linos, Litzner, Missall, Novoa, Sundram, Swick, and Hurley were members of the Appropriate Use Criteria (AUC) Task Force. |
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Drs Alam, Argenyi, Duncan, Elston, Emanuel, Ferringer, Fung, Hosler, Lazar, Lowe, Plaza, Prieto, Robinson, Schaffer, Subtil, and Wang were members of the rating panel. |
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Dr Hurley, as designated, was the Chair of the AUC Task Force / Committee and is the senior author. |
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Drs Kim, Kozel, Litzner, and Sundram were AUC subgroup leaders. |
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Drs Argenyi, Duncan, Ferringer, Fung, Holser, Lowe, Plaza, Prieto, Subtil, and Wang and Emanuel were American Society of Dermatopathology representatives. |
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Dr Elston was the American Society of Dermatopathology President during the time of AUC development. |
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Drs Alam and Robinson were the American Academy of Dermatology representative. |
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Drs Lazar and Schaffer were College of American Pathologist representatives. |
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Funding sources: None. |
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Conflicts of interest: None disclosed. |
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Disclaimer: The recommendations presented in this study were developed using the RAND Corporation (Santa Monica, CA) and University of California, Los Angeles, appropriateness method. Appropriateness ratings represent the best interpretation of the literature combined with expert judgment at the time of their development. The selection of a test ultimately lies with the physician and the assessment of multiple factors associated with the individual patient. The clinical scenarios used should not be considered inclusive of all situations in which a test or study should or can be performed. In the future, with the availability of additional information, changes to these recommendations may be required. |
Vol 80 - N° 1
P. 189 - janvier 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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