In light of new medical evidence, the American College of
Cardiology (ACC) in September withdrew one of its five recommendations in the Choosing Wisely campaign that heart
attack patients question interventions beyond unblocking just the
"culprit" artery responsible for the heart attack.
Wisely uses evidence-based lists developed by medical specialty societies
to call physicians' and patients' attention to potentially overused tests and
procedures that could harm rather than help patients (www.texmed.org/choosingwisely).
The Texas Medical Association sees Choosing
Wisely as a vehicle for quality improvement and is one of five state
medical associations to win a grant to promote the campaign in partnership with
the TMA Foundation.
ACC based its original
recommendation on nonrandomized studies that, at the time, suggested treating
all significantly blocked arteries in heart attack patients could be harmful.
"However, over the last two
years, new science has emerged showing potential improvements for some patients
in their overall outcomes as a result of complete revascularization," ACC
says, pointing to two recent randomized controlled trials and a third under way.
"Science is not static, but
rather constantly changing. As such,
one of the ACC's primary roles is to stay abreast of this evolution and provide
cardiovascular professionals and patients with the most up-to-date information
on which to base decisions about the most appropriate and necessary treatment,"
ACC President Patrick T. O'Gara, MD, said. "The more access patients and providers have to accurate information
about treatment options, the more we can ensure care that is truly necessary,
free from harm, and cost-effective."
He says ACC's clinical guidelines and appropriate use criteria will
address the new research, and the group will work with the ABIM Foundation to
update its Choosing Wisely
As part of the Choosing Wisely
campaign, nearly 60 organizations have published lists of potentially
unnecessary tests, treatments, and procedures that ABIM Foundation Executive
Vice President and Chief Operating Officer Daniel Wolfson says are based on the
latest science and evidence available at their time of publication. Choosing Wisely partners must review their
list at least annually and make any needed updates based on new evidence or
changes to clinical guidelines.
"The ABIM Foundation recognizes that new
research and medical guidelines are published on a regular basis and has
developed a set of operating principles to ensure the accuracy of all Choosing Wisely lists is maintained,"
Texas Medicine, Dec. 2014
Last Updated On
May 13, 2016