TORONTO – The American College of Physicians plans to launch an initiative to assess the benefits, harms and costs of diagnostic tests and treatments for various diseases.
The ACP's "High-Value, Cost-Conscious Care Initiative" is designed to provide physicians and patients with evidence-based recommendations for specific interventions for a variety of clinical problems, said Joseph Stubbs, MD, the organization's president. The intent is to help determine whether treatments provide 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 Stubbs. "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 the ACP, it's essential to assess benefits, harms and costs of an intervention to determine whether it provides good value. Evaluation of the cost of an intervention is insufficient to assess value, said Stubbs. Inexpensive interventions may provide little value, and expensive interventions may provide good value and meet accepted thresholds for clinical and cost effectiveness.
The ACP's Clinical Efficacy Assessment Technical Advisory Committee plans to develop a set of "high-value, cost-conscious care recommendations" that will be submitted for review and consideration for publication in the ACP's journal Annals of Internal Medicine.
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, the ACP's senior vice president for medical education and publishing. The recommendations "will provide evidence about which evaluation and management strategies work best for individual patients."
According to a 2009 ACP policy paper, the Congressional Budget Office 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. The ACP contends in that paper that savings can be achieved by reducing the inappropriate use of services and 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 Stubbs.
The American College of Physicians is the largest medical specialty organization and second-largest physician group in the United States. ACP members include internal medicine physicians, related subspecialists and medical students.
