Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology

Task Force/Committee Members, Rating Panel, Claudia I. Vidal, Eric A. Armbrect, Aleodor A. Andea, Angela K. Bohlke, Nneka I. Comfere, Sarah R. Hughes, Jinah Kim, Jessica A. Kozel, Jason B. Lee, Konstantinos Linos, Brandon R. Litzner, Tricia A. Missall, Roberto A. Novoa, Uma Sundram, Brian L. Swick, M. Yadira Hurley, Murad Alam, Zsolt Argenyi & 14 others Lyn M. Duncan, Dirk M. Elston, Patrick O. Emanuel, Tammie Ferringer, Maxwell A. Fung, Gregory A. Hosler, Alexander Lazar, Lori Lowe, Jose A. Plaza, Victor Prieto, June K. Robinson, Andras Schaffer, Antonio Subtil, Wei-Lien Wang

Research output: Contribution to journalArticle

Abstract

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.

LanguageEnglish (US)
Pages189-207.e11
JournalJournal of the American Academy of Dermatology
Volume80
Issue number1
DOIs
StatePublished - Jan 1 2019

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Physicians
Consensus
Evidence-Based Medicine
Decision Making
Delivery of Health Care
Costs and Cost Analysis
Research
Pathologists

Keywords

  • ancillary studies
  • appropriate use criteria
  • dermatopathology
  • evidence-based medicine
  • expert rating

ASJC Scopus subject areas

  • Dermatology

Cite this

Appropriate use criteria in dermatopathology : Initial recommendations from the American Society of Dermatopathology. / Task Force/Committee Members; Rating Panel.

In: Journal of the American Academy of Dermatology, Vol. 80, No. 1, 01.01.2019, p. 189-207.e11.

Research output: Contribution to journalArticle

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abstract = "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.",
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AU - Bohlke, Angela K.

AU - Comfere, Nneka I.

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AU - Lazar, Alexander

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