The American Association of Neurological Surgeons, Congress of Neurosurgeons and AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves, released their comments on the Washington State Healthcare Authority Health Technology Assessment program, which is reviewing its coverage policy for lumbar spinal fusion.
Here are five things to know about their commenting letter:
• AANS and CNS don't believe new literature warrants a policy revision from the last review, conducted in Nov. 2007.
• The organizations ask that neurosurgeons be included in the development of key research questions and the opportunity to review clinical evidence included in technical assessments prepared for the issue.
• The letter asks that non-surgical alternative treatments be as thoroughly vetted for safety, quality, cost and availability as spinal fusion surgery.
• Neurosurgeons are currently seeking outcomes data for lumbar spinal surgery to create a sustainable healthcare system. AANS run the National Neurosurgery Quality and Outcomes Database.
• The organizations offered to help the program identify neurosurgeon spine experts in Washington to contribute to coverage policy efforts.
"As risk-adjusted benchmarks of surgical morbidity and effectiveness, which define spine surgical quality, have yet to be determined, benchmarks of acceptable quality of care cannot be accurately assessed and practice groups cannot accurately determine areas of their practice where quality improvement should be targeted such as in the case of lumbar fusion," the letter said.
AANS/CNS has participated in previous agency reviews and plans to work closely with the agency again during the upcoming review process.
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