Why the study?
Common clinical scenarios for noninvasive vascular testing in peripheral vascular disease lacked comprehensive appropriate use criteria to guide clinical practice and policy.
What are the appropriate use criteria for peripheral vascular ultrasound and physiological testing?
What are the appropriate use criteria for peripheral vascular ultrasound and physiological testing?
This document provides appropriate use criteria for peripheral vascular ultrasound and physiological testing, rating 255 clinical scenarios to guide physician decision-making and healthcare delivery.
The American College of Cardiology Foundation (ACCF), in partnership with key specialty and subspecialty societies, conducted a review of common clinical scenarios where noninvasive vascular testing (ultrasound and physiological testing) is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of the original appropriate use criteria (AUC). The 159 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). A total of 255 indications (with the inclusion of surveillance timeframes) were rated. One hundred and seventeen indications were rated as appropriate, 84 were rated as uncertain, and 54 were rated as inappropriate. The AUC for peripheral vascular disease have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. Keywords: ACCF Appropriate Use Criteria, abdominal aortic aneurysm, ankle-brachial index, arterial physiological testing, carotid artery disease, duplex ultrasound, mesenteric artery disease, peripheral artery disease, peripheral vascular disease, noninvasive testing, noninvasive vascular laboratory, renal artery stenosis
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Mohler et al. (2012) conducted a review in Peripheral vascular disease. Noninvasive vascular testing (ultrasound and physiological testing) was evaluated on Appropriateness rating of clinical indications. An expert panel rated 255 clinical indications for peripheral vascular ultrasound and physiological testing, finding 117 appropriate, 84 uncertain, and 54 inappropriate.
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