AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery
- PMID: 22959232
- DOI: 10.1016/j.jaad.2012.06.009
AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery
Erratum in
- J Am Acad Dermatol. 2015 Apr;72(4):748
Abstract
The appropriate use criteria process synthesizes evidence-based medicine, clinical practice experience, and expert judgment. The American Academy of Dermatology in collaboration with the American College of Mohs Surgery, the American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery has developed appropriate use criteria for 270 scenarios for which Mohs micrographic surgery (MMS) is frequently considered based on tumor and patient characteristics. This document reflects the rating of appropriateness of MMS for each of these clinical scenarios by a ratings panel in a process based on the appropriateness method developed by the RAND Corp (Santa Monica, CA)/University of California-Los Angeles (RAND/UCLA). At the conclusion of the rating process, consensus was reached for all 270 (100%) scenarios by the Ratings Panel, with 200 (74.07%) deemed as appropriate, 24 (8.89%) as uncertain, and 46 (17.04%) as inappropriate. For the 69 basal cell carcinoma scenarios, 53 were deemed appropriate, 6 uncertain, and 10 inappropriate. For the 143 squamous cell carcinoma scenarios, 102 were deemed appropriate, 7 uncertain, and 34 inappropriate. For the 12 lentigo maligna and melanoma in situ scenarios, 10 were deemed appropriate, 2 uncertain, and 0 inappropriate. For the 46 rare cutaneous malignancies scenarios, 35 were deemed appropriate, 9 uncertain, and 2 inappropriate. These appropriate use criteria have the potential to impact health care delivery, reimbursement policy, and physician decision making on patient selection for MMS, and aim to optimize the use of MMS for scenarios in which the expected clinical benefit is anticipated to be the greatest. In addition, recognition of those scenarios rated as uncertain facilitates an understanding of areas that would benefit from further research. Each clinical scenario identified in this document is crafted for the average patient and not the exception. Thus, the ultimate decision regarding the appropriateness of MMS should be determined by the expertise and clinical experience of the physician.
Copyright © 2012 American Academy of Dermatology, Inc. and the American Society for Dermatologic Surgery, Inc. Published by Mosby, Inc. All rights reserved.
Comment in
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Why appropriate use criteria for Mohs micrographic surgery?J Am Acad Dermatol. 2012 Oct;67(4):551. doi: 10.1016/j.jaad.2012.07.006. Epub 2012 Sep 5. J Am Acad Dermatol. 2012. PMID: 22959231 No abstract available.
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Comment on 2012 appropriate use criteria for Mohs micrographic surgery.J Am Acad Dermatol. 2013 Aug;69(2):317-8. doi: 10.1016/j.jaad.2013.03.040. J Am Acad Dermatol. 2013. PMID: 23866871 No abstract available.
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Reply to "Comment on 2012 appropriate use criteria for Mohs micrographic surgery".J Am Acad Dermatol. 2013 Aug;69(2):318. doi: 10.1016/j.jaad.2013.04.014. J Am Acad Dermatol. 2013. PMID: 23866872 No abstract available.
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