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. 2021 Dec 1;98(7):1349-1357.
doi: 10.1002/ccd.29784. Epub 2021 Jun 3.

The appropriate use criteria: Improvements for its integration into real world clinical practice

Lloyd W Klein  1 , Jacqueline Tamis-Holland  2 , Ajay J Kirtane  3 , H Vernon Anderson  4 , Joaquin Cigarroa  5 , Peter L Duffy  6 , James Blankenship  7 , C Michael Valentine  8 , Frederick Gp Welt  9 ; AUC Workgroup of the ISLC Endorsed by the Interventional Section Leadership Council, American College of Cardiology
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The appropriate use criteria: Improvements for its integration into real world clinical practice

Lloyd W Klein et al. Catheter Cardiovasc Interv. .

Abstract

The purpose of this position statement is to suggest ways in which future appropriate use criteria (AUC) for coronary revascularization might be restructured to: (1) incorporate improvement in quality of life and angina relief as primary goals of therapy, (2) integrate the findings of recent trials into quality appraisal, (3) employ the combined information of the coronary angiogram and invasive physiologic measurements together with the results of stress test imaging to assess risk, and (4) recognize the essential role that patient preference plays in making individualized therapeutic decisions. The AUC is a valuable tool within the quality assurance process; it is vital that interventionists ensure that percutaneous coronary intervention case selection is both evidence-based and patient oriented. Appropriate patient selection is an important quality indicator and adherence to evidence-based practice should be one metric in a portfolio of process and outcome indicators that measure quality.

Keywords: Appropriate use; Coronary PCI; Quality.

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References

REFERENCES

    1. Klein LW, Harjaj KJ, Resnic F, et al. Revision of the SCAI position statement on public reporting. Catheter Cardiovasc Interv. 2017;89(2):269-279.
    1. Patel MH, Calhoon JH, Dehmer GJ, et al. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 appropriate use criteria for coronary revascularization in patients with stable ischemic heart disease. J Am Coll Cardiol. 2017;69:2212-2241.
    1. Welt FGP, Klein LW, Tamis-Holland J, et al. Views of appropriate use criteria (AUC) for catheterization and percutaneous coronary revascularization by practicing interventional cardiologists: results of a survey of ACC interventional section members. Catheter Cardiovasc Interv. 2019;93(5):875-879.
    1. Klein LW, Anderson HV, Rao SV. Proposed framework for the optimal measurement of quality assessment in percutaneous coronary intervention. JAMA Cardiol. 2019;4:963-964. https://doi.org/10.1001/jamacardio.2019.3228.
    1. Marso SP, Teirstein PS, Kereiakes DJ, Moses J, Lasala J, Grantham JA. Percutaneous coronary intervention use in the United States: defining measures of appropriateness. JACC Cardiovasc Interv. 2012;5(2):229-235.

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