Getting it right: optimizing the patient and technique for the procedure.

The methodological approach to decision making in optimizing medical care has focused on using the best available evidence with the primary endpoint being patient outcome. Through this emphasis, quality becomes relegated as the quintessential factor in determining application of medical intervention and in directing resource allocation. When evidence is inconclusive or absent, then clinical judgment becomes elevated in the decision analysis schema. The paucity of well designed controlled trials in perfusion technology has resulted in a greater reliance on clinical judgment than published information. This has created an environment where significant variability exists throughout the perfusion community. The following report will discuss several reasons for this variability, and describe techniques where the preponderance of evidence is available supporting inclusion in perfusion practice.