One thing many people tend to forget about evidence-based medicine, is that although optimally all care should be based in evidence, there are many conditions for which the evidence base is sparse. Where evidence doesn’t exist to support care, patients still need care. In these cases, recommendations can be based on the existing level of evidence along with clinician expertise until the quality of the evidence catches up.  Knowing that research moves forward in steps rather than leaps and bounds, in the current environment of accountability and limited resources the demand for care recommendations from other sources continues to grow.

To meet the demand for care recommendations for members, patients, policy makers and other stakeholders in the spine field, NASS has begun developing  appropriate use criteria (AUC).  This initial foray into appropriateness criteria is based on a modified version of the RAND method, currently the most accepted methodology for generating AUC. The first topic to be addressed is cervical fusion. It is anticipated that the first set of criteria will completed in the fall of 2012.

Appropriateness criteria are another tool NASS can provide to members to assist them in defining and providing quality care, as well as acquiring appropriate reimbursement.