Our Methodology

The MSK Breast and Imaging Center/ CT Scan

This is our facility at the Evelyn H. Lauder Breast Center in New York.

Memorial Sloan Kettering has mapped out a structured methodology to define appropriate use criteria (AUC) for advanced diagnostic imaging exams tailored to our patient population.

Define the Specific Needs of Cancer Patients

Care requirements for patients with cancer are very different from those for other patients. We have created multidisciplinary teams, called Imaging Disease Management Teams (IDMTs), that bring together medical experts from across MSK to discuss the unique clinical scenarios they observe in our patient population.

The concept of multidisciplinary Disease Management Teams (DMTs) was introduced at MSK more than 20 years ago. DMTs are made up of specialists from a wide range of disciplines, who meet regularly to discuss individual patient treatment strategies. DMTs function as the heart of team-based decision-making and innovative research. The IDMTs are an extension of this well-established model, with a specific focus on advanced imaging. They are charged with developing, modifying, or endorsing AUC in subspecialized clinical domains based on priority clinical areas (PCAs) defined by the Centers for Medicare and Medicaid Services (CMS), clinical practice needs, and existing evidence.

Review Existing Scientific Evidence

The Evidence-based Cancer Imaging Program (ECIP) has implemented a structured methodology for reviewing evidence to support appropriate use criteria (AUC) for advanced diagnostic imaging exams.

The MSK Library and Biostatistics faculty are integral to the IDMT evidentiary review process. Research informationists from the MSK Library develop and execute a search strategy to identify published research and best-practice recommendations in the existing medical literature. This ensures that our patients benefit from the collective knowledge of other academic institutions and medical societies.

IDMT members discuss the results of the evidentiary review and identify evidence to support the AUC. The evidence is graded independently by both research informationists and biostatisticians using the Oxford Centre for Evidence-Based Medicine grading system. With this information in hand, IDMT members collaborate to apply their in-depth knowledge to determine what imaging standards are appropriate for patients with cancer. 

Ensure Our Unique Patient Needs are Met

Advances in science and research associated with identifying optimal cancer care are never-ending. As a result, we are always striving to identify the best solutions. We are continually establishing new IDMTs, monitoring the evidence published in medical literature, and learning from our own internal observations. Our Clinical Council for Cancer Imaging (CCCI) serves as our overall steering committee and governing body to ensure this process stays on point. In the same way that we look to leverage the expertise of others where it exists, MSK also openly shares our knowledge to ensure the best care for oncology patients everywhere.

Learn more about our Appropriate Use Criteria Development Methodology.

To learn more about the team of experts focused on this process, see Our Team.