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1.
J Am Acad Orthop Surg ; 26(9): e191-e193, 2018 May 01.
Article in English | MEDLINE | ID: mdl-29688919

ABSTRACT

The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) for Surgical Management of Osteoarthritis of the Knee. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Surgical Management of Osteoarthritis of the Knee AUC clinical patient scenarios were derived from indications of patients under consideration for surgical treatment of osteoarthritis of the knee as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the three treatments. The 864 patient scenarios and 3 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 9-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).


Subject(s)
Osteoarthritis, Knee/physiopathology , Osteoarthritis, Knee/surgery , Arthroplasty, Replacement, Knee , Clinical Decision-Making , Contraindications, Procedure , Hemiarthroplasty , Humans , Osteoarthritis, Knee/complications , Osteotomy , Patient Selection , Practice Guidelines as Topic
3.
J Am Acad Orthop Surg ; 26(6): e128-e130, 2018 Mar 15.
Article in English | MEDLINE | ID: mdl-29420323

ABSTRACT

The American Academy of Orthopaedic Surgeons (AAOS) has developed Appropriate Use Criteria (AUC) for Management of Carpal Tunnel Syndrome. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. To provide the evidence foundation for this AUC, the AAOS Evidence-Based Medicine Unit provided the writing panel and voting panel with the 2016 AAOS Clinical Practice Guideline titled Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline. The Management of Carpal Tunnel Syndrome AUC clinical patient scenarios were derived from indications typical of patients with suspected carpal tunnel syndrome in clinical practice, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of treatments. The 135 patient scenarios and 6 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 9-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).


Subject(s)
Carpal Tunnel Syndrome/therapy , Clinical Decision-Making/methods , Decision Support Techniques , Orthopedics/methods , Evidence-Based Medicine , Humans , Orthopedics/standards , Practice Guidelines as Topic
4.
J Am Acad Orthop Surg ; 25(7): e138-e141, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28582338

ABSTRACT

The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics. The 64 patient scenarios and 1 treatment 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 9-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).


Subject(s)
Dental Care/methods , Orthopedics , Prostheses and Implants , Dental Care/standards , Humans , United States
5.
J Am Acad Orthop Surg ; 25(5): e102-e104, 2017 May.
Article in English | MEDLINE | ID: mdl-28379914

ABSTRACT

Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the Appropriate Use Criteria (AUC) document Treatment of Hip Fractures in the Elderly to improve patient care and obtain optimal outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from indications typical of patients commonly presenting with hip fractures in clinical practice, as well as from current evidence-based clinical practice guidelines and supporting literature. The 30 patient scenarios and 6 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. A separate, multidisciplinary Voting Panel made up of specialists and nonspecialists rated the appropriateness of treatment of each patient scenario using a 9-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).


Subject(s)
Decision Making , Hip Fractures/therapy , Aged , Contraindications, Procedure , Humans , Risk
7.
J Am Acad Orthop Surg ; 25(1): e11-e14, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27906771

ABSTRACT

Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the Appropriate Use Criteria (AUC) document Postoperative Rehabilitation of Low Energy Hip Fractures in the Elderly to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from patient indications that typically accompany hip fractures, as well as from current evidence-based clinical practice guidelines and supporting literature. The 72 patient scenarios and 10 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. A separate, multidisciplinary Voting Panel made up of specialists and nonspecialists rated the appropriateness of treatment of each patient scenario using a 9-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).


Subject(s)
Arthroplasty/rehabilitation , Hip Fractures/rehabilitation , Practice Guidelines as Topic , Aged , Aged, 80 and over , Clinical Decision-Making/methods , Hip Fractures/surgery , Humans
8.
J Am Acad Orthop Surg ; 24(9): e102-4, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27479835

ABSTRACT

The American Academy of Orthopaedic Surgeons has developed the Appropriate Use Criteria (AUC) document Management of Osteochondritis Dissecans of the Femoral Condyle. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from patient indications that generally accompany osteochondritis dissecans of the femoral condyle, as well as from current evidence-based clinical practice guidelines and supporting literature. The 64 patient scenarios and 12 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Lastly, a separate, multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-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).


Subject(s)
Clinical Decision-Making/methods , Disease Management , Orthopedics/standards , Osteochondritis Dissecans/therapy , Practice Guidelines as Topic , Femur , Humans , Orthopedics/organization & administration , Societies, Medical
9.
J Am Acad Orthop Surg ; 24(8): e81-3, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27355285

ABSTRACT

The American Academy of Orthopaedic Surgeons has developed the Appropriate Use Criteria (AUC) document Treatment of Anterior Cruciate Ligament Injuries. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from patient indications that generally accompany an anterior cruciate ligament injury, as well as from current evidence-based clinical practice guidelines and supporting literature. The 56 patient scenarios and 8 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Lastly, a separate, multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-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).


Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament Injuries/rehabilitation , Anterior Cruciate Ligament Injuries/therapy , Exercise Therapy/methods , Exercise Therapy/standards , Humans , Plastic Surgery Procedures/methods , Plastic Surgery Procedures/standards
10.
J Am Acad Orthop Surg ; 24(2): e21-3, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26735703

ABSTRACT

The American Academy of Orthopaedic Surgeons has developed the Appropriate Use Criteria (AUC) document Management of Pediatric Supracondylar Humerus Fractures With Vascular Injury. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from patient indications that generally accompany a pediatric supracondylar humerus fracture with vascular injury, as well as from current evidence-based clinical practice guidelines and supporting literature. The 6 patient scenarios and 18 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Next, the Review Panel, a separate group of volunteer physicians, independently reviewed these materials to ensure that they were representative of patient scenarios that clinicians are likely to encounter in daily practice. Finally, the multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-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).


Subject(s)
Humeral Fractures/surgery , Vascular System Injuries/surgery , Child , Humans , Humeral Fractures/complications , Pain Management , Vascular System Injuries/complications
12.
J Am Acad Orthop Surg ; 23(10): e49-51, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26320161

ABSTRACT

The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) on the Management of Pediatric Supracondylar Humerus Fractures (PSHF). Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The PSHF AUC clinical patient scenarios were derived from patient indications that generally accompany a PSHF as well as from current evidence-based clinical practice guidelines and supporting literature. The 220 patient scenarios and 14 treatments were developed by the Writing Panel, a group of clinicians who are specialists in this AUC topic. Next, the Review Panel, a separate group of volunteer physicians, independently reviewed these materials to ensure that they were representative of patient scenarios that clinicians are likely to encounter in daily practice. Finally, the multidisciplinary Voting Panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-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).


Subject(s)
Humeral Fractures/surgery , Humerus/injuries , Orthopedics/standards , Practice Guidelines as Topic , Child , Evidence-Based Medicine/standards , Humans , Orthopedics/methods , Peer Review, Health Care/methods
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