DOCSLIB.ORG

Escmid News 3 3008 Final.Pdf

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Escmid News 3 3008 Final.Pdf 3 /2008 ESCMID SOCIETY ESCMID Web Relaunch in NEWS November 2008 page 4 PROFESSIONAL AFFAIRS Report and Photo Gallery: The ESCMID Professional Affairs Workshop page 15 Survey of Clinical Microbiology and Infectious Diseases in Europe – ESCMID Opens Country- specific Websites page 20 Tasks and Possible Benefi ts of a Closer Liaison. Between CMs and IDs Specialists: Sharing Responsibilities. Starting ID Day Prompt Diagnosis Resistance Protection from from the CM Lab! (CM) Surveillance (CM) Antimicrobial Resistance (CM+ID) Reduction of Antibiotic Policies Appropriateness of Application of Antimicrobial (ID+CM) Antimicrobial PK/PD (ID) Resistance therapy (ID) (CM+ID) Surgical Hospital Hospital Infection Written guidelines Prophylaxis (ID) Epidemiology Control (CM+ID) for diagnosis and (CM+ID) therapy of Infections Diseases (ID+CM) In this Issue Table of Contents Society Science and Education 3 Editorial 26 Reports on Training in a Foreign Institution: 4 Vote Now and Elect Your Representatives! – Role of Lipooligosaccharide Locus Classes 4 ESCMID Web Relaunch in November 2008 in Diversity and Invasion Potential of 5 From the Executive Campylobacter Jejuni 6 Messages from the CMI Editors – A Quest for Antibiotic Treatment 8 Joint ESCMID and FEMS Research Alternatives for Cholera in an Era of Fellowships Challenging Antimicrobial Resistance 9 ESCMID Scholarships 2008 – Rotavirus Surveillance in Bulgaria – Present State and Future Directions Professional Affairs 32 Course Review: 7th ESCMID Summer 15 Report and Photo Gallery: The ESCMID School 2008 Professional Affairs Workshop Erratum 20 Survey of Clinical Microbiology and Infectious Diseases in Europe – ESCMID Calendar Opens Country-specifi c Websites 34 Forthcoming Events 24 ESCMID Observerships and Collaborative Centres 25 UEMS: The First Meeting of the Section of Medical Microbiology ESCMID News Copyright for articles accepted in the next month‘s issue. Printer Ex offi cio member Newsletter of the European for publication is shared Hofmann Druck P Cologna, Managing Director, Society of Clinical Microbiology between ESCMID and the Distribution and Emmendingen, DE Basel, CH and Infectious Diseases author(s). circulation number ESCMID News is sent via post ESCMID Ad hoc members Editors and editorial offi ce Editorial statement to all ESCMID members and Executive Committee F Baquero, 18th ECCMID Giuseppe Cornaglia, Despite careful editing and is distributed at international G Cornaglia, President, Verona, IT President, Madrid, ES ESCMID President, responsible setting, ESCMID, the editors conferences for information SR Norrby, Past President, P Huovinen, 19th ECCMID for content; and Hofmann Druck cannot about ESCMID‘s activities. Stockholm, SE President, Turku, FI Peter Cologna, ESCMID be liable for any errors or Circulation number: 5’000 M Akova, Education Offi cer, G Schmid, Editor CMI Managing Director; inaccuracies in this publication. Ankara, TR Supplements, Geneva, CH Dianne White, Publications; Opinions expressed are those Change of address J Garau, President-elect and D Raoult, CMI Editor-in-Chief, Editorial Offi ce: of the contributing authors. Notice of change of address Secretary General, Barcelona, ES Marseille, FR ESCMID Executive Offi ce, can be given via the ESCMID G Kahlmeter, Professional Affairs PO Box, 4002 Basel, Number of website or can be sent to Offi cer, Clinical Microbiology, Copyright © European Society Switzerland, [email protected] issues and editorial deadlines Birgit Menzemer, ESCMID Vaxjo, SE of Clinical Microbiology and ESCMID News appears Membership Offi ce, E Nagy, Treasurer, Szeged, HU Infectious Diseases 2008. All Manuscripts and copyright three times per year in April, PO Box 1131, 82018 R Read, Professional Affairs rights reserved. Non- The editorial team welcomes September and December. Taufkirchen, Germany, Offi cer, Infectious Diseases, commercial reproduction your manuscripts, Manuscripts must arrive at the [email protected]. Sheffi eld, UK authorized, subject to graphics and photographs Editorial Offi ce (preferably J Vila, Scientifi c Affairs Offi cer, acknowledgment of source. for publication, especially by email) by the 15th of the Design Barcelona, ES from ESCMID Study Groups, previous month if they are Flux Design Studios, A Voss, ECCMID Programme collaborators and third parties. to be considered for publication Basel, CH Director, Nijmegen, NL Professional Affairs Editorial vey of the profi le of professional activity, accredi- tation and training in ID and CM in European na- tions is now completed. Many thanks go to the Professional Affairs Subcommittee for their help in its design and testing. The survey will greatly aid professional mobility and exchange throughout Europe and help ESCMID lobby our political mas- ters on behalf of all the membership. More detailed information about this initiative can be found on page 20. Clinical practice guidelines are an important contribution of any large clinical society such as ours, and over the past 2 years we have accelerated our involvement in this area with investment in several major initiatives (see Table). Again, the Professional Affairs Subcommittee has provided valuable advice to us, resulting directly in the re- Robert Read, Professional Affairs Offi cer cent commissioning of European guidelines on for Infectious Diseases (ID) and sore throat. Gunnar Kahlmeter, Professional Affairs Offi cer Finally, ESCMID hosted an important Profes- for Clinical Microbiology (CM) sional Affairs Workshop in Rome from 9–10 Octo- ber. A large number of presentations on the theme This issue of ESCMID News is strongly devoted to “Working together over borders” (national borders, Professional Affairs. The past year has seen borders between specialties, professions, organiza- ESCMID dramatically increase its involvement in tions, etc.) were given and discussed by the 140 this area of activity. The two of us have greatly en- delegates from all over Europe, including many joyed this partnership spurred on by the more than trainees in both disciplines. Discussion was lively gentle prodding of the President, Giuseppe Corna- and wide ranging (see details by Winfried Kern on glia. page 15). Proceedings of this meeting will be pub- One year ago we were pleased to co-chair the lished in Clinical Microbiology and Infection in fi rst meeting of the ESCMID Professional Affairs 2009, and we certainly are looking forward to the Subcommittee (for members see page 16), a multi- next PA Workshop. national group of infectious disease physicians and clinical microbiologists which also includes the Medical guideline developments chairmen of the UEMS Section for Infectious Dis- – International Guidelines for Management of eases (Mike McKendrick, UK) and the recently ap- Severe Sepsis and septic Shock (in coopera- proved UEMS Section for Medical Microbiology tion with the Surving Sepsis Campaign, pub- (John Degener, NL). From the fi rst meeting of this lished in Crit. Care Med. 2008; 36:296–327) group sprang the ideas that developed into the – Guidelines on the diagnosis and management ESCMID Collaborative Centres and the ESCMID of Clostridium diffi cile-associated disease Observerships (described in detail on page 24). It (ESCMID guidelines, ongoing, led by Ed is our hope that many infectious disease units and Kuijpers, Leiden, NL) clinical microbiology laboratories as well as cen- – Lower Respiratory Tract Infection (ongoing, tres of research will put themselves forward as in cooperation with ERS) ESCMID Collaborating Centres. In this way the – Endocarditis (ongoing, in cooperation with Observerships should get off to a fl ying start in the ECS) New Year. – Catheter-related Urinary Tract Infection (on- The creation and updating of an accurate alma- going, in cooperation with IDSA) nac of the profi le of Infectious Diseases and Clini- – Urinary Tract Infection (ongoing, in cooper- cal Microbiology is an important goal for ation with IDSA) ESCMID. We are pleased to announce that the sur- – Sore throat, led by Pentti Huovinen ESCMID NEWS 02/2008 SOCIETY 3 Vote Now and Elect Your Representatives! Dear ESCMID member, The election platform is now open to all members in good standing (1 full year of paid membership). For some of our colleagues in the Executive Com- Please use this opportunity to cast your vote for mittee, their terms will expire in May 2009. Rag- your colleagues, so we can ensure that your spe- nar Norrby will retire from his function as Past cialty is well represented for the next term of 4 President, while Gunnar Kahlmeter’s and Robert years. Read’s 1st terms as Professional Affairs Offi cers Please go to www.escmid.org/election, log on end, but they are running for re-election. with your member ID and password and cast your For the term starting next May, we have three vote by 22 December. openings in the Committee: one in Clinical Micro- Best regards, biology and two in Infectious Diseases. We are pleased to report that seven excellent candidates have been nominated in the respective fi elds: Clinical Microbiology Infectious Diseases – Barry Cookson – Pierre Dellamonica – Gunnar Kahlmeter – Matthew Falagas – Johan Mouton – Winfried Kern Javier Garau, – Robert Read President-elect and Secretary General ESCMID Web Relaunch in November 2008 One and a half years ago we gave the ESCMID Searching is improved, especially in the Dates & website a new “look” to match the new ESCMID Events section. Here you can generate lists of corporate design and logo. This was announced as events with specifi c search criteria. a transitional
Load more

Recommended publications
  • SB 122 Evidence-Based Health Insurance Benefits Background
    SB 122 Evidence-Based Health Insurance Benefits Background: Evidence-based medical practice reviews are performed by professional societies (e.g. American College of Physicians) and standard setting organizations such as the Oregon Health Evidence Review Commission (HERC) (ORS 414.690) to encourage the use of best current scientific evidence and analysis of comparative effectiveness in the delivery of medical care (pharmaceuticals, technologies, medical equipment, services and procedures) and third-party coverage decisions. These reviews and guidelines (or guidances) represent a proven strategy for quality improvement and practice consistency. In many instances, empirical evidence has demonstrated that they have generated considerable cost- savings, as well. Problem and Opportunity: Although the strategy, itself, has been shown to be effective, its overall impact depends on the degree to which practitioners apply the reviews and guidelines in actual patient care. Adherence rates have varied geographically and by service or procedure. A study of cancer specialists in a large specialty network reported that 54% complied with evidence-based guidelines; a similar study of Michigan cardiologists indicated statewide average adherence to guidelines for cardiac angioplasty of 57% with a range of 45%-82% across hospital referral regions. The problem is: how to increase practitioner adherence to gold-standard evidence-based medical reviews and guidelines. Approach: Insurance benefit design can be an important element of a robust strategy for reducing healthcare costs and improving quality and consistency of care. One way the strategy could work would be to limit covered benefits to those services (including procedures, pharmaceuticals, devices and supplies) that met evidence-based guidelines. This approach could be applied to a limited number of covered benefits on a pilot basis to demonstrate its feasibility and to work out any kinks.
    [Show full text]
  • Advancing Evidence-Based Practice in Primary Care Physiotherapy
    Linköping University Medical Dissertation No. 1486 Advancing evidence-based practice in primary care physiotherapy Guideline implementation, clinical practice, and patient preferences Susanne Bernhardsson Division of Physiotherapy Department of Medical and Health Sciences Linköping University, Sweden Linköping 2015 Susanne Bernhardsson, 2015 Cover art: “Not black or white”, © Lucas McNabb, 2015 Published articles have been reprinted with the permission of the respective copyright holder. Papers I and II have been reprinted from Phys Ther. 2013;93:819–32 and Phys Ther. 2014;94:343–354 with permission of the American Physical Therapy Association. ©2013 and ©2014, respectively, of the American Physical Therapy Association. Paper IV has been reprinted from J Eval Clin Pract. 2015; Epub 2015 May 19, with permission of John Wiley & Sons, Ltd. ©2014 John Wiley & Sons, Ltd. Copyright for Paper III is held by the authors. Printed in Sweden by LiU-Tryck, Linköping, Sweden, 2015 ISBN: 978-91-7685-935-3 ISSN: 0345-0082 Knowing is not enough; we must apply. Willing is not enough; we must do. —Johann Wolfgang von Goethe, 1749-1832 Contents TABLE OF CONTENTS ABSTRACT ................................................................................................................................i LIST OF PUBLICATIONS .................................................................................................... iii ABBREVIATIONS ................................................................................................................. iv TERMS
    [Show full text]
  • Topic 10: Patient Safety and Invasive Procedures
    Topic 10: Patient safety and invasive procedures Why patient safety is relevant to Although the principles described in this topic are surgery and invasive procedures 1 important for both surgical and invasive There is now plenty of evidence to show that procedures, most of the evidence in the literature patients who undergo a surgical or an invasive relates to surgical care. procedure are at increased risk of suffering an adverse event [1-3]. This is not because the Learning outcomes: knowledge and surgeons and proceduralists are careless or performance incompetent, rather it is because we now know about the many opportunities for things to go What does a student need to know wrong because of the many steps involved in (knowledge requirements): 3 surgical procedures. In addition, there are the • the main types of adverse events problems caused by surgical site infections that associated with surgical and invasive account for a significant proportion of all health procedures care; care-associated infections. This topic will assist • the verification processes for improving students to understand how patient safety surgical and invasive procedures care. principles can assist in minimizing adverse events associated with invasive procedures. There are What a student needs to do (performance many validated guidelines now available to assist requirements): 4 the health-care team deliver safe surgical care. • follow a verification process to eliminate There may not be many opportunities for students wrong patient, wrong side and wrong to implement many of these steps to improve procedure; surgical outcomes. Nonetheless they can observe • practise operating room techniques that how the health professionals communicate with reduce risks and errors (time-out, briefings, one another and what techniques they use to debriefings, stating concerns); make sure they are operating on the correct person • participate in an educational process for or doing the procedure on the correct body part.
    [Show full text]
  • Empyema UHL Childrens Medical Guideline
    LRI Children’s Hospital Empyema UHL Childrens Medical Guideline Staff relevant to: Medical & nursing staff caring for Children admitted to UHL Children’s Hospital with para-pneumonic effusions and empyema. Team approval date: June 2019 AWP approval date: January 2020 Version: 3 Revision due: January 2023 Written by: M Narayanan Trust Ref: C127/2016 1. Introduction and Who Guideline applies to This guideline is particularly applicable to para-pneumonic effusions and empyema in Children admitted to UHL Children’s Hospital. It should be read alongside the community acquired pneumonia guideline and the chest drain in children guideline. This guideline does not apply to the following special situations: 1) Empyema following trauma 2) Iatrogenic empyema (e.g. due to mediastinal or pleural procedures). 3) High suspicion of non-infective pathology (e.g. malignancy). The original version of this guideline was based on the recommendations issued by the BTS in 2005 (1). Considering that the original BTS recommendation is now dated, this revision takes into account other evidence, and evidence based guidance issued by other authorities (2, 3). Related documents: UHL ref C62/2019 - Chest Drain Management UHL Childrens Hospital Guideline UHL ref C96/2016 - Pneumonia - Inpatient UHL Childrens Hospital Guideline UHL ref C8/2019 - Tuberculosis UHL Childrens Hospital Guideline Page 1 of 12 Title: Empyema UHL Childrens Medical Guideline V: 3 Approved by Children’s Clinical Practice Group on: June 2019, AWP approval: January 2020 Trust Ref: C127/2016 Next Review: January 2023 NB: Paper copies of this document may not be most recent version. The definitive version is held in the Trust Policy and Guideline Library.
    [Show full text]
  • The Quality of Clinical Practice Guidelines in Traditional Medicine In
    Choi et al. Implementation Science (2015) 10:104 DOI 10.1186/s13012-015-0294-1 Implementation Science RESEARCH Open Access The quality of clinical practice guidelines in traditional medicine in Korea: appraisal using the AGREE II instrument Tae-Young Choi1†, Jiae Choi1†, Ju Ah Lee1, Ji Hee Jun1, Bongki Park2 and Myeong Soo Lee1* Abstract Background: This study aimed to evaluate the quality of the current clinical practice guidelines (CPGs) in traditional medicine (TM) in South Korea using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to further enhance the CPG development. Methods: A search was performed for guidelines in Korea from inception until March 2014 in the major Korean guideline websites [the Korean Medical Guideline Information Centre (KoMGI), the Korean Guideline Clearing House (KGC)], PubMed and seven Korean electronic databases; the Association of Korean Oriental Medicine (AKOM) was also consulted. Five independent assessors rated the quality of each CPG using the AGREE II instrument and calculated the mean score of each AGREE item. The overall agreement amongst reviewers was evaluated using the intra-class correlation coefficient (ICC). Results: Initially, 17 CPGs were examined for TM in Korea, and only 8 CPGs satisfied the inclusion criteria. The mean scores for each AGREE II domain were as follows: (1) scope and purpose, 60.0 % (CIs, 45.05-74.94 %); (2) stakeholder involvement, 56.11 % (41.28-70.94 %); (3) rigour of development, 42.7 % (23.48-61.92 %); (4) clarity and presentation, 62.50 % (50.89-74.10 %); (5) applicability, 20.31 % (13.96-26.66 %); and (6) editorial independence, 44.58 % (10.78-78.38 %).
    [Show full text]
  • Radiofrequency Ablation of Tumors
    Radiofrequency Ablation of Tumors Last Review Date: May 7, 2021 Number: MG.MM.SU.52cC2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth the clinical evidence that the patient meets the criteria for the treatment or surgical procedure. Without this documentation and information, EmblemHealth will not be able to properly review the request for prior authorization. The clinical review criteria expressed below reflects how EmblemHealth determines whether certain services or supplies are medically necessary. EmblemHealth established the clinical review criteria based upon a review of currently available clinical information (including clinical outcome studies in the peer reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). EmblemHealth expressly reserves the right to revise these conclusions as clinical information changes and welcomes further relevant information. Each benefit program defines which services are covered. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered and/or paid for by EmblemHealth, as some programs exclude coverage for services or supplies that EmblemHealth considers medically necessary. If there is a discrepancy between this guideline and a member's benefits program, the benefits program will govern. In addition, coverage may be mandated by applicable legal requirements of a state, the Federal Government or the Centers for Medicare & Medicaid Services (CMS) for Medicare and Medicaid members.
    [Show full text]
  • Enhanced Controls Needed to Assure Validity of Medicare Hospice
    , ... DEPARTMENT OF HEALTH & HUMAN SERVICES Office of Inspector General Memorandum Nov 41997 Date June Gibbs Brown From Inspector Gener B Subject Enhanced Contro@ ceded to Assure‘“ Validity of Medicare Hospice Enrollments (A-05 -96-OO023) To Nancy-Ann Min DeParle Deputy Administrator Health Care Financing Administration Attached are two copies of our final report entitled “Enhanced Controls Needed to Assure Validity of Medicare Hospice Enrolhnents.” The objective of this report was to consolidate and present issues disclosed by our ongoing Project Operation Restore Trust (ORT) audits of Medicare hospice services. Some of the hospices which we have audited and referred to in this report are also the subject of continuing Office of Inspector General (OIG) review. The Medicare hospice program, while highly respected and successful in its mission, is a program which has experienced a substantial number of ineligible enrolhnents as identified in our audits. The reviews focused on determining whether the beneficiaries met the Medicare definition of “terminally ill” at the time of enrolhnent in the hospice program. The audits covered 12 large hospices located in 4 ORT States (Illinois, Florida, Texas, and California). Working with us, physicians from Medicare Peer Review Organizations (PRO’s) reviewed the medical files of all 2,109 long-term beneficiaries in those hospices that had been in care over 210 days, or that had been discharged fkom hospice at some point after reaching the 210 day threshold. The PRO physicians conch.ided that 1,373 of the selected beneficiaries were ineligible for hospice because, at the time of initial diagnosis, they were not terminally ill as defined by Medicare regulations, i.e., having a life expectancy of 6 months or less (we hereinafter use the phrase “terminally ill” as defined in Medicare regulations).
    [Show full text]
  • Private Regulation
    PRIVATE REGULATION RONEN AVRAHAM* INTRODUCTION ............................................................546 I. THE VARIOUS COSTS OF THE HEALTHCARE SYSTEM...........................................554 A. Costs Associated with Underuse ................556 B. Costs Associated with Misuse .....................557 C. Costs Associated with Overuse...................558 1. Defensive Medicine ................................558 2. Offensive Medicine.................................559 3. Cost‐apathetic Medicine ........................561 4. Compassionate Medicine.......................561 D. Summary ........................................................562 II. IS CURRENT MEDICAL MALPRACTICE LAW THE ANSWER?...............................................563 A. Can Tort Law Tackle the Healthcare System’s Costs?..............................................563 B. Can Current CPGs Tackle the Costs of the Healthcare System?............................568 1. When the Government Writes Guidelines ................................................568 * Thomas Shelton Maxey Professor of Law, University of Texas at Austin. I thank Jennifer Arlen, Bernie Black, Oren Bracha, Richard Epstein, John Golden, Clark Havighurst, Mark Hall, David Hyman, Timothy Jost, Ariel Porat, Osama Mikhail, Arnold Rosoff, Bill Sage, Catherine Sharkey, Charlie Silver, and the participants of the Interdisciplinary Center in Israel Faculty Colloquium (Mar. 2011), the American Society of Law, Medicine and Ethics Annual Meeting (June 2010), the American Association of Law and
    [Show full text]
  • How Often Do Medical Management Guidelines Change for People with Germline Genetic Findings?
    October 2019 How Often Do Medical Management Guidelines Change for People with Germline Genetic Findings? A Solution for Keeping Patients and Providers Updated www.MyGeneCounsel.com THE EVOLUTION OF GENETIC TESTING Since the completion of the mapping of the human genome in 2003, there has been exponential growth in clinical genetic testing. Genetic testing was once more limited and much more focused. Testing for single syndromes, ranging from Huntington disease to breast and ovarian cancer susceptibility, was customary. This evolved into widespread use of multigene panels that test many genes simultaneously for a common indication, such as hereditary cancer or cardiac disease. Early panels analyzed from 10 to 25 genes, while newer multigene panels can include analysis of hundreds of genes. Whole-exome and whole-genome tests, analyzing the coding regions or complete genomes of individuals, respectively, are becoming more common, even as first tier tests1. In a 2018 study that described the clinical genetic 75,000+ testing landscape, it was estimated that there were Genetic tests on the market 75,000 genetic tests on the market, with up to 10 new tests introduced daily2. Of these tests, 14 10 percent were multigene panels, whole-exome, or New genetic tests whole-genome tests. introduced each day To add to the complexity, direct-to-consumer (“DTC”) genetic testing has exploded. More than 26 26,000,000 People have had consumer million people have already undergone DNA testing DNA testing by submitting their saliva samples via at-home spit kits to gain insight into things like ancestry, fitness and lifestyle traits, and health information3.
    [Show full text]
  • IL Individual Health Exchange Catastrophic HMO Policy
    IL Individual Health Exchange Catastrophic HMO Policy IL_IND_CAT_HMO_HIX_2020 Health Alliance Medical Plans complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Health Alliance Medical Plans does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. Health Alliance Medical Plans: • Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats, other formats) • Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages If you need these services, contact customer service. If you believe that Health Alliance Medical Plans has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Health Alliance Medical Plans, Customer Service, 3310 Fields South Drive, Champaign, Illinois 61822, telephone: 1-866-247-3296, TTY: 711, fax: 217-902-9705, [email protected]. You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, Customer Service is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S.
    [Show full text]
  • Ambulatory Monitoring Electroencephalogram (EEG)
    Ambulatory Monitoring Electroencephalogram (EEG) Last Review Date: May 7, 2021 Number: MG.MM.ME.76a Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth the clinical evidence that the patient meets the criteria for the treatment or surgical procedure. Without this documentation and information, EmblemHealth will not be able to properly review the request for prior authorization. The clinical review criteria expressed below reflects how EmblemHealth determines whether certain services or supplies are medically necessary. EmblemHealth established the clinical review criteria based upon a review of currently available clinical information (including clinical outcome studies in the peer reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). EmblemHealth expressly reserves the right to revise these conclusions as clinical information changes and welcomes further relevant information. Each benefit program defines which services are covered. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered and/or paid for by EmblemHealth, as some programs exclude coverage for services or supplies that EmblemHealth considers medically necessary. If there is a discrepancy between this guideline and a member's benefits program, the benefits program will govern. In addition, coverage may be mandated by applicable legal requirements of a state, the Federal Government or the Centers for Medicare & Medicaid Services (CMS) for Medicare and Medicaid members.
    [Show full text]
  • Xofigo® for Castration-Resistant Prostate Cancer
    Xofigo® for Castration-Resistant Prostate Cancer Last Review Date: January 12 , 2018 Number: MG.MM.RA.07b Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth the clinical evidence that the patient meets the criteria for the treatment or surgical procedure. Without this documentation and information, EmblemHealth will not be able to properly review the request for prior authorization. The clinical review criteria expressed below reflects how EmblemHealth determines whether certain services or supplies are medically necessary. EmblemHealth established the clinical review criteria based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). EmblemHealth expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information. Each benefit program defines which services are covered. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered and/or paid for by EmblemHealth, as some programs exclude coverage for services or supplies that EmblemHealth considers medically necessary. If there is a discrepancy between this guideline and a member's benefits program, the benefits program will govern. In addition, coverage may be mandated by applicable legal requirements of a state, the Federal Government or the Centers for Medicare & Medicaid Services (CMS) for Medicare and Medicaid members.
    [Show full text]