Should ACE scores be part of routine exams?

Some early experiences may shape future health, yet physicians are not required to use the Adverse Childhood Experiences exam to help assess patient risk, according to NPR.

The ACE exam was developed in the 1990's and requires patients to answer 10 yes or no questions about formative experiences before age 18. Many physicians, including Vincent Felitti, MD, who helped conduct research to create the tool, and Jeff Brenner, MD, a MacArthur Fellows award-winner, believe the ACE exam would be a useful addition to routine physical examinations, according to the report.

ACE scores are not widely used because they are not taught in medical schools, they can't be billed for and there are no established practices to use them, according to the report. However, the chief reason the questionnaire is not regularly employed is physician personal discomfort, Dr. Felitti told NPR. Some physicians feel there is not enough time in an appointment to broach such difficult topics.

Dr. Brenner told NPR the ACE score is"still really the best predictor we've found for health spending, health utilization; for smoking, alcoholism, substance abuse. It's a pretty remarkable set of activities that healthcare talks about all the time."

Yet other physicians point out there have not been any randomized controlled trials that show the ACE tool makes a difference, according to the report.

The report suggests the need for more research regarding the effectiveness of the tool for a large population size.

 

More articles on integration and physician issues:

New AAMC estimate: US will need up to 90,000 physicians by 2025
Half of physicians don't use prescription drug monitoring programs
How hospitals can avoid physician impostors

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