The AUC and Me

Over the last several years, there has been a plethora of discussion swirling around the appropriate use criteria (AUC); some of it reasoned but most, simply vitriolic. I have led projects attempting to use the AUC to extract data from electronic health records for quality improvement purposes, been witness to efforts to use the AUC in place of radiology benefits managers, and participated in numerous conversations related to the terms used to describe the categories and even the techniques employed to organize the classification for each scenario discussed.  I have learned a tremendous amount… but mostly I’ve learned that we really don’t know squat about what we are doing! Medically, we don’t really know the correct treatment most of the time.  Although it might seem obvious to us in reflection, it is certainly not clear to the public that the great majority of what we do is rooted in best guess, we think it will work, expert consensus type evidence, not in “proven fact.”  More significantly, we have a history of being wrong, occasionally famously.  Examples such as “bypass surgery will prevent heart attack”, “antibiotics make a difference in otitis media”, and “frequent stress testing helps predict outcome” dot our historical landscape.  There are numerous others.  They all have in common the fact that we thought we knew what we were doing when we didn’t. We d...
Source: ACC in Touch Blog - Category: Cardiology Authors: Tags: Health Policy and Practice Management Clinical Topics Source Type: blogs