An international panel of experts applied the RAND/UCLA Appropriateness Method to develop criteria for use of peripherally inserted central catheters (PICCs). The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) is published as a supplement in Annals of Internal Medicine.
Use of PICCs has become popular for venous access in hospital settings but their use can result in important complications, such as thrombosis and infection. In addition, a growing number of studies suggest substantial variation and potentially inappropriate use of PICCs in hospitalized patients. For example, PICCs may not be placed for clinically valid reasons. In the absence of high-quality evidence, physicians need guidance to help them make choices regarding appropriate use of medical devices.
Researchers organized and conducted a multidisciplinary meeting of international experts to develop appropriateness criteria for use, care, and management of PICCs and related venous access devices. Following the RAND/UCLA Appropriateness Method, the panel conducted systematic reviews of the literature and created scenarios related to PICC use, care, and maintenance based on patient population, indication for insertion, and duration of use. For each scenario, appropriateness of PICC use was compared with that of other venous access devices.
The supplement is accompanied by a continuing medical education quiz and maintenance of certification activity.
Guide: The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA Appropriateness Method, Vineet Chopra, MD, MSc; Scott A. Flanders, MD; Sanjay Saint, MD, MPH; Scott C. Woller, MD; Naomi P. O’Grady, MD; Nasia Safdar, MD, PhD; Scott O. Trerotola, MD; Rajiv Saran, MD, PhD; Nancy Moureau, BSN, RN; Stephen Wiseman, PharmD; Mauro Pittiruti, MD; Elie A. Akl, MD, MPH, PhD; Agnes Y. Lee, MD, MSc; Anthony Courey, MD; Lakshmi Swaminathan, MD; Jack LeDonne, MD; Carol Becker, MHSA; Sarah L. Krein, PhD, RN; and Steven J. Bernstein, MD, MPH, Annals of Internal Medicine, doi:10.7326/M15-0744, published 15 September 2015.