ACP to provide physicians, patients with evidence-based recommendations for clinical problems

Program will make specific recommendations for high-value diagnostic tests and medical treatments across a range of medical conditions

Building on its existing foundation of clinical and public policies, the American College of Physicians (ACP) announced plans to provide physicians and patients with evidence-based recommendations for specific interventions for a variety of clinical problems. ACP's High-Value, Cost-Conscious Care Initiative will assess benefits, harms, and costs of diagnostic tests and treatments for various diseases to determine whether they provide good value -- medical benefits that are commensurate with their costs and outweigh any harms.

"Physicians and patients need evidence-based information so they can make the right decision about the right treatment at the right time," said Joseph W. Stubbs, MD, FACP, President, ACP. "High-value, cost-conscious care is about eliminating overused and misused medical treatments that do not improve patient health or might even be harmful."

According to ACP, it is essential to assess benefits, harms, and costs of an intervention to determine whether it provides good value. Evaluation of the costs of an intervention is insufficient to assess value; inexpensive interventions may provide little value, and expensive interventions may provide good value and meet accepted thresholds for clinical and cost effectiveness.

The initiative will include the development of ACP's High-Value, Cost-Conscious Care Recommendations by ACP's Clinical Efficacy Assessment Technical Advisory Committee that will be submitted for review and consideration for publication in Annals of Internal Medicine. The effort will address common medical conditions for which inappropriate use of resources is known to be an issue such as low back pain.

The next edition of ACP's Medical Self-Assessment Program (MKSAP) will also have a focus on optimal diagnostic and treatment strategies, based upon considerations of value, effectiveness, and avoidance of overuse and misuse. Additional phases of the initiative may include patient education materials and curricula for medical students and residents.

"Shared decision-making between physicians and patients is an integral part of high-value, cost-conscious care," said Steven Weinberger, MD, FACP, Deputy Executive Vice President and Senior Vice President, Medical Education and Publishing, ACP. "ACP's High-Value, Cost-Conscious Care Recommendations will provide evidence about which evaluation and management strategies work best for individual patients."

According to ACP's 2009 policy paper, Controlling Health Care Costs While Promoting the Best Possible Health Outcomes, the Congressional Budget Office (CBO) estimates that 5 percent of the nation's Gross Domestic Product -- $700 billion per year -- is spent on tests and procedures that do not actually improve health outcomes. ACP contends in that paper that savings can be achieved by reducing inappropriate utilization of services and by encouraging clinically effective care based on comparative effectiveness research.

"By eliminating medical treatments that do not directly improve a patient's health, physicians and patients can significantly reduce waste and preserve high-quality care," said Dr. Stubbs.