As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.
Duke Health satisfies CMS criteria to be a qPLE by having followed these steps: 1) work was led by a multidisciplinary team 2) conflicts of interest by team members were managed 3) a process was developed for selecting a priority clinical area 4) a formal evidentiary review process was completed, and 5) Appropriate Use Criteria were published. This work’s aim is to reduce care pathway variability, institute best practices, and improve the quality of care that is delivered to Duke Health patients.
AUC FOR ADVANCED IMAGING
Duke Health has implemented a structured approach for the creation, modification, or endorsement of AUCs for Priority Clinical Areas and other advanced imaging indications within the health system.
DUHS utilizes a publicly transparent process for identifying and resolving potential conflicts of interest for all participating members of the appropriate use criteria development, modification or endorsement.
LITERATURE REVIEW & EVIDENCE GRADING
Duke Health utilizes an evidentiary review process when developing of modifying AUCs by performing its own literature searches and creating evidence tables.
All appropriate use criteria endorsed, developed, or modified by the Imaging AUC program are reviewed annually.
STEERING AND GOVERNANCE COMMITTEE MEMBERS
The Steering and Governance Committee functions as the leadership group and has autonomous governance, decision-making, and accountability to develop, modify, and/or endorse imaging AUC for Duke Health. The committee identifies and prioritizes topics for imaging AUC and incorporates anticipated future CMS guidance regarding clinical priority areas. The chair appoints additional providers and experts for specific AUC topics to meet the requirement of at least one practicing physician with expertise in the clinical topic related to the AUC being developed or modified and at least one practicing physician with expertise in the imaging studies related to the AUC. Thus, for each clinical topic, the personnel available between the committees includes at least seven members: appropriate clinical experts, at least one expert in statistical analysis, and at least one expert in clinical trial design.
CHRISTOPHER J. ROTH, M.D., M.M.C.I.
Associate Professor of Radiology and Neuroradiology, Vice Chair of Radiology for Clinical Informatics and IT, Director of Imaging Informatics Stategy, Statistical Analysis
DEVDUTTA SANGVAI, M.D., M.B.A
ACMO Vice President for Population Health Management, Vice Chair for Quality and Safety
MOMEN M. WAHIDI, M.D.
Professor of Medicine
Director, Interventional Pulmonology and Bronchoscopy Chief Medical Officer, Duke Patient Revenue Management Organization
SUBJECT MATTER EXPERTS
The multidisciplinary team of subject matter experts includes practicing Duke Health providers representing radiology, primary care, and population health. Depending on what priority clinical area is developing AUC, subject matter experts may be added to the team. Several team members on the Steering Committee and Subject Matter Experts Committee have expertise in clinical trial design, research methodology, statistical analysis, medical informatics, quality assurance, patient safety, clinical operations, and information systems.
ISAAC O. KARIKARI, M.D.
DANIELLE SAIKALI, M.S.N, F.N.P.-C.