title: Appropriate use criteria: a review of need, development and applications.
abstract: The costs of healthcare in developed countries have seen a dramatic increase in tandem with the increasing utilization of diagnostic testing. As a result, Appropriate Use Criteria (AUC)-based practices have become more commonplace as a provider-driven solution to reducing unnecessary tests and procedures across various specialty societies. The AUC are meant to serve as a distinct entity from clinical guidelines to help inform clinicians of the 'appropriateness' of a diagnostic test or procedure. In this article, we discuss the development, implementation, impact, and practical applications of AUC to improve appropriate utilization by providers, healthcare institutions, payers, and policy makers. We also focus on the role of education and feedback as a potentially efficacious future method of implementation of global quality improvement and cost-mitigating strategies. AUC represent a growing quality improvement tool in cardiovascular medicine that can play an important role in reducing inappropriate testing while preserving physician autonomy.
authors.affiliation: a Women's College Hospital Institute for Health Systems Solutions and Virtual Care , Toronto , ON , Canada.|b Peter Munk Cardiac Centre of the University Health Network , Toronto General Hospital , Toronto , ON , Canada.|c Department of Medicine, University of Toronto Medical School , Toronto , ON , Canada.
authors.forename: R Sacha
authors.initials: RS
authors.lastname: Bhatia
authors.affiliation: d University of Ottawa Medical School , Ottawa , ON , Canada.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Alabousi
authors.affiliation: e Division of Cardiology , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Dudzinski
authors.affiliation: e Division of Cardiology , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Rory B
authors.initials: RB
authors.lastname: Weiner
mesh_terms: D002309:Cardiology / Q000592:standards*; D006801:Humans
keywords: Quality improvement; appropriate use criteria; cardiology; echocardiography; health policy