September 26, 2018
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AAOS endorses appropriate use criteria for monitoring recurrence of bone, soft tissue sarcomas

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The American Academy of Orthopaedic Surgeons has endorsed new appropriate use criteria released by the Musculoskeletal Tumor Society to help doctors determine when to use X-rays, ultrasounds, CT scans and other imaging to help patients at risk for recurrence of bone or soft tissue sarcomas.

“The sarcoma surveillance [appropriate use criteria] AUC allows for both clinicians and patients to benefit from the best data available on sarcoma recurrence and metastatic patterns. It provides standardization of practices so that we can know how to best find metastatic disease and local recurrences given a variety of clinical factors,” Rajiv Rajani, MD, co-chair of the appropriate use criteria project and associate professor and vice chair for education in the department of orthopedic surgery at UT Health San Antonio, said in a press release. “The AUC allows patients to receive the best-known practices for sarcoma surveillance.”

A derivative of the clinical practice guideline approved earlier this year, the appropriate use criteria includes a mix of guidelines and expert opinion meant to aid physicians in monitoring patients after they have had surgery to treat bone or soft tissue sarcomas, according to the release. Appropriate use criteria are accessed through an online tool that rates the appropriateness of certain services depending on patients’ indications, can aid doctors in deciding when and how to use imaging to detect cancer and inform shared decision-making with patients. The tool includes 3-month, 6-month and 1-year intervals and may be used to improve outcomes and reduce unnecessary costs.

“The [tool’s] value is in delivering assistance to these practitioners to help determine what studies to order and how often to order them,” Benjamin J. Miller, MD, co-chair of the appropriate use criteria project, said in the release. “Just as important, the AUC defines studies that are unlikely to be helpful and should be avoided. This project could potentially reduce unnecessary imaging and result in cost reduction by minimizing over-imaging by frequency and modality. In contrast, if clinicians are not performing surveillance at close enough intervals, it may increase utilization but result in earlier identification of treatable sites of recurrent disease.”

Reference:

newsroom.aaos.org/media-resources/news/american-academy-of-orthopaedic-surgeons-endorses-the-musculoskeletal-tumor-societys-appropriate-use-criteria-that-informs-doctors-monitoring-of-bone-and-soft-tissue-sarcoma-survivors.htm