Guidelines and statements By Luke Wilkins, MD, FSIR What kind of guideline should
ach year, SIR’s Guidelines and Statements division produces multiple high-quality documents designed to ensure patient
safety, enhance the delivery of care and improve practice paradigms.
These documents are compiled by volunteer members, SIR staff , and even other societies. In recent years, SIR has expanded the quantity and type of documents provided. Luke Wilkins, MD, FSIR, the counselor of the Guidelines and Statements division, discusses the various document types, how they’re developed and how they can best inform IR therapies and practices.
The Guidelines and Statements Division recently worked with SIR’s Renal and Genitourinary Clinical Specialty Council to create a practice guidance document for the creation of a percutaneous arteriovenous fi stulae program. Can you tell us why authors developed a Practice Guidance Document, rather than a clinical practice guideline? Luke Wilkins, MD, FSIR: The traditional guidelines and statements papers that we think of are clinical practice guidelines (CPGs), position statements, and reporting standards documents. However, IR has a very fast pace of innovation, and so sometimes we have regularly performed procedures that do not have a standard methodology applied to them that would fi t within a clinical practice guideline. This is because some of the recommendations that you make in a CPG are supported by data-driven studies that rely on
you use? An FAQ with Guidelines and Statements counselor Luke Wilkins, MD, FSIR
randomized controlled trials and meta-analyses of multiple randomized controlled trials. But because we are such a technologically-driven specialty, sometimes innovation outpaces our ability to have randomized trials.
However, our members still need guidance on the best practices for different types of procedures. This is where a practice guidance document comes in (PGD). These are ideal for procedures that we regularly perform, which have good evidence to support them, but not the robust evidence needed for a CPG. There is a real need for a document that can help members know when to do what, what to look
for, and which patient population will most benefit from the therapies that we are providing.
The PGD encompasses a lot of diff erent aspects, not just clinically, but also guidance on billing or patient acquisition. Why did the authors choose to include this? Dr. Wilkins: One of the selling points of our PGDs is that they have some elements of fl exibility built into them where they can be a document that provides guidance, soup to nuts. It can answer what clinical information you need, Imaging recommendations pre-procedure and how to perform the procedure. But it can also include billing
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