Department of Cardio-Thoracic Surgery, Erasmus University Medical Center, Thoraxcenter, Rotterdam, The Netherlands.
Semin Thorac Cardiovasc Surg. 2012 Winter;24(4):241-3. doi: 10.1053/j.semtcvs.2012.11.005.
Appropriate use criteria integrate guidelines, clinical trial evidence, and expert opinion in order to determine the most appropriate care for a range of distinct clinical scenarios. Inappropriate use estimates cannot be neglected. Approximately 12%-14% of all percutaneous coronary interventions and 1%-2% of all coronary artery bypass grafting procedures in patients with stable angina are deemed inappropriate. Several reasons for this difference are identified. Continuous improvement of the criteria, multidisciplinary discussions, and the correct financial incentives will be essential in reducing the number of inappropriate procedures, improve patient outcomes, and contain costs.
适宜性使用标准综合了指南、临床试验证据和专家意见，旨在确定一系列不同临床情况下最合适的治疗方案。不可忽视不适当使用的估计。在稳定性心绞痛患者中，大约 12%-14%的经皮冠状动脉介入治疗和 1%-2%的冠状动脉旁路移植术被认为是不适当的。确定了导致这种差异的几个原因。不断改进标准、多学科讨论以及正确的财务激励措施对于减少不适当的手术数量、改善患者的治疗结果和控制成本至关重要。
