These criteria propose that emergency or urgent revascularization for patients with acute coronary syndromes is generally considered appropriate. However, for elective revascularization, several important features should be considered in determining appropriateness of cases, including symptom status, degree of ischemia, anatomy, and current medical therapy. These ele- ments are central to the data that should be captured as the indicationformostrevascularizationprocedures.Therefore,the initial goal of measure 1 (comprehensive documentation of indications for PCI) and measure 2 (appropriate indication for elective PCI) is to ensure that adequate information for assessing the indication for revascularization procedures is captured and reported, so that continued evaluation and feed- back to improve both the AUC ratings and clinical care can occur. 4.1.2. Patient Education/Shared Decision-Making Measures Although the aforementioned factors highlight the dif- culty of determining when PCI is clinically indicated, reaching a high-quality decision goes beyond meeting the AUC. In an area in which decision making is so com- plex, performance measurement ideally also would address how the decision was made. This is necessary because patient preferences can play an important role in many cases, especially with regard to elective PCI. For example, some patients whose medical history and diagnostic testing results suggest PCI is indicated might still want to consider other options. Conversely, there will be patients for whom it is equivocal whether PCI is indicated, but the patient nonetheless expresses a strong preference to undergo PCI. The ideal approach to decision making is to involve the patient to the extent he or she wishes to be involved. Performance measurement should re ect this process as much as possible. 