• CLINICAL INTEREST SECTIONS: Congenital Coronary Peripheral SCAI TAVR Center

  • A Mischaracterization of Appropriate Use Criteria

    October 31, 2013

    This post was authored by Ted A. Bass, MD, FSCAI, SCAI President and John Gordon Harold, MD, MACC, ACC President.

    An article published Tuesday by Bloomberg News regarding the changes in Appropriate Use Criteria (AUC) methodology released earlier this year, mischaracterizes the intent of the change.

    The new methodology, published this past February in the Journal of the American College of Cardiology, included changes to frequently misinterpreted terminology for describing the levels of appropriateness of care. Specifically, the new methodology changed the original ratings of appropriate, uncertain, and inappropriate, to appropriate, may be appropriate and rarely appropriate.


    The new terminology and definitions were made in order to more accurately reflect how AUC should be used both for quality improvement and clinically, including consideration for physician judgment, measurement of patterns of use over time and the potential hazard of applying inflexible rules to individual patient situations. Other medical societies that have AUC also use terminology similar to the ACC’s updated terms.

    Contrary to what the article implies, nothing has changed about the AUC process or the commitment of ACC, SCAI and other partnering societies to improving practice through AUC. If nothing else, the criteria are stronger than ever before.

    At the end of the day, AUC are designed to help ensure the best information is available for clinical decision making and help support appropriate choices by physicians and patients, in the context of good clinical judgment and patient preferences. There’s nothing inappropriate about that!