Draft Formal response to agency for healthcare research and quality (AHRQ) technical brief on neurothrombectomy devices in acute ischemic stroke

In the current environment of health policy reform, physicians must increasingly engage the federal system to inform the government regarding the state of the science and to advocate on behalf of their patients for the continued provision of necessary care. The Agency of Health Research and Quality (AHRQ), within the Department of Health and Human Services (DHHS), provides scientific advice to the Centers for Medicare and Medicaid Services (CMS) regarding the efficacy and cost-effectiveness of existing therapeutic modalities. These Technical Briefs provide the scientific basis for Medicare reimbursement policies. Recently, the AHRQ produced a Draft Technical Brief on Mechanical Thrombectomy for Acute Ischemic Stroke. This document potentially endangers future reimbursement for endovascular stroke care. The link to the Technical Brief is: http://effectivehealthcare.ahrq.gov/index.cfm/research- available-forcomment/comment-draftreports/? pageactiondisplaydraftcommentform&topicid161&productid418& documenttypedraftReport. The endovascular neurosurgery group at the University of Buffalo produced a formal response. The following FORUM piece represents this response, and draws upon their substantial institutional experience. This piece will likely provide the foundation for a larger, multispecialty response, including American Association of Neurological Surgeons/Congress of Neurological Surgeons, SCAI, and possibly SNIS. Coordination of such an effort remains a work in progress. This piece offers the amalgam of policy and science central to WORLD NEUROSURGERY and provides a timely window to an evolving policy with dramatic implications for the neurosurgery community.