DECEMBER 20218Dr. Christopher Buckle, Medical Director, Radiology, AIM Specialty HealthByAdvances in radiology have transformed the diagnosis and management of medical diseases across the care continuum. Lung cancer screening for high risk patients, early diagnosis of multiple sclerosis, staging and therapy response in lymphoma, aneurysm surveillance are just a few examples of the way imaging has led to earlier and more accurate diagnosis or created more sophisticated ways to plan treatment or assess response. But with new opportunities come new challenges. What is the significance of an incidental finding? What are the consequences of false positive studies that lead to unnecessary anxiety, testing and potentially treatment? What harms ­ direct or indirect ­ occur when patients are tested too frequently? Appropriate use programs like prior authorization or clinical decision supportseek to balance the benefits and harms of advanced diagnostic testing. Many appropriate use criteria for advanced imaging have been developed by a variety of government agencies, specialty societies, providers and payers alike. But what does appropriate use even mean? There is a wide range. For some,appropriate use occurs only when there is high quality evidence showing that the test improves the outcome of patients. For others, any study that experts deemappropriate suffices as a definition. At AIM Specialty Health, we believe it is important to have a transparent definition or framework of appropriate use applied consistently across imaging requests. While that might seem daunting given the sheer breadth and complexity of modern imaging requests, we have seen consistent themes emerge across a diverse array of imaging guideline developers that appropriate use requires a few key principles: CLINICAL APPROPRIATENESS GUIDELINES MAKE A DIFFERENCE FOR PROVIDERS, PATIENTSDr. Christopher BuckleIn My Opinion
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