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ACC
ICD/CRT Appropriate Use Criteria Survey
This is the survey for collecting user feedback on ACC's tool:
ICD/CRT Appropriate Use Criteria
.
Responses to this survey are anonymous. No personal information is collected. We use responses to these surveys to continually improve ACC's web and mobile tool offerings.
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* Indicates required question
1. In which of the following ways have you used the ICD/CRT Appropriate Use Criteria App? (Select all that apply)
*
As a tool to support my own clinical decision making
To facilitate a discussion with a patient during a visit
To consult the likelihood of CMS coverage of a treatment option for a patient
To facilitate the documentation process (i.e. have a record of the appropriateness rating of a treatment for a given patient)
To facilitate treatment discussions across specialties
To guide or teach others at my practice/institution
As an informational reference
As a patient, to review my risk and treatment options
Other:
Required
2. What other tools have you used to help make decisions about ICD and CRT therapy for your patients?
2013 ACC/HRS ICD/CRT Appropriate Use Criteria document
2012 ACC/AHA Device-Based Therapy Guideline document
ACC ICD Clinical Data Registry reports
Other:
3. Which information or function within the app is most useful to you? (Select all that apply)
Appropriate use score (I.e., Appropriate, May Be Appropriate, Rarely Appropriate)
CMS Advice (i.e., Coverage can be expected/Coverage cannot be expected)
Ability to email results
3, continued. Please provide comments on your answer to question 3, if applicable.
Your answer
4. Overall, how useful is the ICD/CRT AUC App to you?
Very Useful
Useful
Somewhat useful
Not very useful
Not at all useful
Clear selection
4, continued. Please provide comments on your answer to question 4, if applicable.
Your answer
5. Would you recommend the ICD/CRT AUC App to a colleague?
Yes
No
Clear selection
6. Which best describes your clinical designation?
General Cardiologist
Electrophysiologist
Cardiac Surgeon
Primary Care Physician
Physician Assistant
Nurse Practitioner
Registered Nurse
Pharmacist
Medical Trainee or Student
Patient
Other:
Clear selection
7. Which best describes your current practice environment?
Private Practice
Hospital
Anticoagulation Clinic
Other:
Clear selection
8. Do you practice primarily in the US or internationally?
I practice primarily in the U.S.
I practice primarily internationally
Clear selection
8, continued. If international, please specify which country (or countries).
Your answer
9. Which best describe how often you use other clinical decision support apps?
Daily
Weekly
Monthly
Yearly
Never
Clear selection
9, continued. If you use other clinical decision support apps, what are they?
Your answer
10. What suggestions do you have for improving the ICD/CRT Appropriate Use Criteria App?
Your answer
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