• Timothy R Deer, Nagy Mekhail, David Provenzano, Jason Pope, Elliot Krames, Simon Thomson, Lou Raso, Allen Burton, Jose DeAndres, Eric Buchser, Asokumar Buvanendran, Liong Liem, Krishna Kumar, Syed Rizvi, Claudio Feler, David Abejon, Jack Anderson, Sam Eldabe, Philip Kim, Michael Leong, Salim Hayek, Gladstone McDowell, Lawrence Poree, Elizabeth S Brooks, Tory McJunkin, Paul Lynch, Leo Kapural, Robert D Foreman, David Caraway, Ken Alo, Samer Narouze, Robert M Levy, Richard North, and Neuromodulation Appropriateness Consensus Committee.
• Center for Pain Relief, Charleston, WV, USA.
• Neuromodulation. 2014 Aug 1;17(6):571-97; discussion 597-8.

IntroductionThe International Neuromodulation Society (INS) has determined that there is a need for guidance regarding safety and risk reduction for implantable neurostimulation devices. The INS convened an international committee of experts in the field to explore the evidence and clinical experience regarding safety, risks, and steps to risk reduction to improve outcomes.MethodsThe Neuromodulation Appropriateness Consensus Committee (NACC) reviewed the world literature in English by searching MEDLINE, PubMed, and Google Scholar to evaluate the evidence for ways to reduce risks of neurostimulation therapies. This evidence, obtained from the relevant literature, and clinical experience obtained from the convened consensus panel were used to make final recommendations on improving safety and reducing risks.ResultsThe NACC determined that the ability to reduce risk associated with the use of neurostimulation devices is a valuable goal and possible with best practice. The NACC has recommended several practice modifications that will lead to improved care. The NACC also sets out the minimum training standards necessary to become an implanting physician.ConclusionsThe NACC has identified the possibility of improving patient care and safety through practice modification. We recommend that all implanting physicians review this guidance and consider adapting their practice accordingly.© 2014 International Neuromodulation Society.

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