New writing committee opportunity available:
- Manuscript Title: The Current Status of PCI without Onsite Surgery: An Update of the 2007 SCAI Expert Consensus Document
- Chair: Dr. Gregory Dehmer
- Please send 1) self-nomination 2) Statement of Interest and 3) a current CV to Sheila Agyeman at email@example.com. SCAI membership is required.
- If you have any known relationships with industry (RWI) relevant to this topic please include them in your submission.
- Due Wednesday, February 1st ; however, all applicants are presented to Chair as first come, first serve.
- Writing committee is limited to 8 interventional cardiologists, including the Chair.
For more details…
Manuscript Title: The Current Status of PCI without Onsite Surgery: An Update of the 2007 SCAI Expert Consensus Document
Intended Audience: Interventionalists, lay public, policy makers, outside medical societies
Environmental Scan Summary: New 2011 PCI guidelines; ACC/AHA/SCAI Clinical Competence Statement (currently under development), CPORT-Elective (likely published in full manuscript soon) JAMA Meta-analysis by Mandeep Singh (in press), other recent papers on PCI without onsite surgery and the volume/outcome relationship.
Subject Summary: In 2007 SCAI published the Expert Consensus Document on this topic. SCAI’s document has been used to construct regulations in several states and has been widely quoted. Perhaps the greatest acknowledgement (although silent) of SCAIs efforts and leadership is found in the new 2011 PCI guidelines. Not only has the classification of elective PCI without onsite surgery been upgraded, but tables from SCAIs document are duplicated as the “standard” in the new PCI guidelines. Although some might consider this a dead issue at this point, there are new issues to consider as the delivery of PCI continues to change in the US. Before the 2007 document was written many smaller facilities wanted to develop PCI programs as there were considerable financial benefits. That has changed as PCI is no longer as profitable as in the past. Overall, PCI volumes are down in the US and with this come important issues of facility and operator volume requirements. The Competency document under development will address some of this, but it is unlikely to address all of the practical issues. This update to the ECD would likely need to wait until the writing committee of the Competency document has reach final conclusions (which would be included), but preparation for an update to SCAIs ECD should begin now. Moreover, as the Mission Lifeline program continues to be promoted, there are relevant questions about developing systems of care and PCI referral centers. Given these considerations, is it still reasonable for smaller facilities with low volume operators to exist for the purpose of providing primary PCI in their community? There are many possible issues about which SCAI could comment and maintain a leadership role. My point in submitting this request at this time is to stimulate discussion as to whether this should or should not be organized at this point. The answer may be no, but I believe this should be discussed.
Outline: The update document would be considerably shorter than the original document. Major sections would include: a) current status of states allowing PCI without onsite surgery (a map like in the original document), b) current status of interventional procedure volumes in the US, c) new guideline classification of elective procedures, d) requirements for such programs, e) facility and operator volume recommendations, f) procedures appropriate for sites without onsite surgery, g) coverage issues – should high volume interventionalists cover low volume facilities, etc . ..) quality monitoring for facilities without onsite surgery, i) conclusions