ACP Clinical Practice Guidelines cover many areas of internal medicine, ranging from screening to diagnosis and treatment of disease. The evidence-based guidelines provide recommendations to help clinicians deliver the best health care possible.
ACP High Value Care Advice and Best Practice Advice focus on high value care that assist physicians to provide the best possible care to their patients while simultaneously reducing unnecessary costs to the healthcare system
Recent Best Practice Advice:
Evaluation of patients with suspected acute pulmonary embolism: Best Practice Advice from the Clinical Guidelines Committee of the American College of Physicians
Published online first in Annals of Internal Medicine on September 29, 2015 (print date November 3, 2015)
Available at http://annals.org/article.aspx?articleid=2443959
Best Practice Advice 1: Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered.
Best Practice Advice 2: Clinicians should not obtain d-dimer measurements or imaging studies in patients with a low pretest probability of PE and who meet all Pulmonary Embolism Rule-Out Criteria.
Best Practice Advice 3: Clinicians should obtain a high-sensitivity d-dimer measurement as the initial diagnostic test in patients who have an intermediate pretest probability of PE or in patients with low pretest probability of PE who do not meet all Pulmonary Embolism Rule-Out Criteria. Clinicians should not use imaging studies as the initial test in patients who have a low or intermediate pretest probability of PE.
Best Practice Advice 4: Clinicians should use age-adjusted d-dimer thresholds (age × 10 ng/mL rather than a generic 500 ng/mL) in patients older than 50 years to determine whether imaging is warranted.
Best Practice Advice 5: Clinicians should not obtain any imaging studies in patients with a d-dimer level below the age-adjusted cutoff.
Best Practice Advice 6:Clinicians should obtain imaging with CT pulmonary angiography (CTPA) in patients with high pretest probability of PE. Clinicians should reserve ventilation-perfusion scans for patients who have a contraindication to CTPA or if CTPA is not available. Clinicians should not obtain a d-dimer measurement in patients with a high pretest probability of PE.
Upcoming Best Practice Advice:
Improved adherence to therapy and clinical outcomes while containing costs: opportunities from the greater use of generic medications. Best Practice Advice from the Clinical Guidelines Committee of the American College of Physicians
Online first publication in Annals of Internal Medicine on November 24, 2015 (print date January 5, 2016).
Click here for more ACP guidelines.
Click here for ACP High Value Care Advice.