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MedCAC Urges More Research On Lymphedema Diagnosis And Treatment

This article was originally published in The Gray Sheet

Executive Summary

U.S. interest groups representing the nation's more than two million lymphedema patients must band together to create a more comprehensive body of clinical evidence on the disease, according to members of the Medical Evidence Development and Coverage Advisory Committee

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AHRQ posts review on secondary lymphedema

Agency for Healthcare Research and Quality's finalized technology assessment on the diagnosis and treatment of secondary lymphedema says that more research is needed to gather evidence on the optimal testing protocol, optimal frequency and duration of treatment, the most efficacious treatment combinations, the length of time for which persons should be tested or treated for lymphedema and whether certain tests or treatments may benefit some types of patients more than others. The report, dated May 28, updates a draft report released last November (1"The Gray Sheet" Nov. 18, 2009). It also adds evidence from non-English-language studies that were excluded from the earlier technology assessment and that were requested by a Medicare Evidence Development & Coverage Advisory Committee that met in Baltimore last November (2"The Gray Sheet" Nov. 23, 2009). Because much of the available evidence on secondary lymphedema comes from studies of breast cancer patients, the report says, diagnostic tests should also be evaluated in non-breast cancer populations before they are widely used for the condition

AHRQ posts review on secondary lymphedema

Agency for Healthcare Research and Quality's finalized technology assessment on the diagnosis and treatment of secondary lymphedema says that more research is needed to gather evidence on the optimal testing protocol, optimal frequency and duration of treatment, the most efficacious treatment combinations, the length of time for which persons should be tested or treated for lymphedema and whether certain tests or treatments may benefit some types of patients more than others. The report, dated May 28, updates a draft report released last November (1"The Gray Sheet" Nov. 18, 2009). It also adds evidence from non-English-language studies that were excluded from the earlier technology assessment and that were requested by a Medicare Evidence Development & Coverage Advisory Committee that met in Baltimore last November (2"The Gray Sheet" Nov. 23, 2009). Because much of the available evidence on secondary lymphedema comes from studies of breast cancer patients, the report says, diagnostic tests should also be evaluated in non-breast cancer populations before they are widely used for the condition

Reimbursement In Brief

CMS updates coverage policy on PET for cervical cancer: The Medicare agency finds there is now enough evidence to call positron emission tomography for cervical cancer "reasonable and necessary" for staging cervical cancer patients, and will no longer require data collection as a condition of coverage (1"The Gray Sheet" May 18, 2009). CMS will cover one PET scan for staging beneficiaries with biopsy-proven cervical cancer to help determine the location or extent of the tumor. Coverage is limited to the following therapeutic uses: to determine if the patient is a good candidate for an invasive diagnostic or therapeutic procedure; to determine the best anatomic location for an invasive procedure; or to determine the anatomic extent of a tumor when treatment depends on the extent of the tumor. The imaging test remains non-covered as a tool to diagnose cervical cancer. This recent decision does not restrict the use of PET scans already covered for detection of metastases during the pre-treatment management phase of patients with newly diagnosed and locally advanced cervical cancer who show no extra-pelvic metastasis on conventional imaging tests such as CT or MRI (2"The Gray Sheet" April 13, 2009)

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