American Academy of Orthopaedic Surgeons/Major Extremity Trauma and Rehabilitation Consortium Appropriate Use Criteria: Pharmacologic, Physical, and Cognitive Pain Alleviation for Musculoskeletal Extremity/Pelvis Surgery

The Major Extremity Trauma and Rehabilitation Consortium and the American Academy of Orthopaedic Surgeons developed an Appropriate Use Criteria (AUC) titled The Pharmacologic, Physical, and Cognitive Pain Alleviation for Musculoskeletal Extremity/Pelvis Surgery . Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care, aid decision making, and obtain the best possible outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC was derived by identifying clinical indications typical of patients undergoing pelvic or extremity surgery. These indications were most often parameters observable by the clinician, including symptoms or results of diagnostic tests. The 480 patient scenarios and 10 treatments were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a nine-point scale to designate a treatment as "appropriate" (median rating, 7 to 9), "may be appropriate" (median rating, 4 to 6), or "rarely appropriate" (median rating, 1 to 3).