Abstract
The International Forum is held once a year by the ESR and its international radiological partner societies with the aim to address and discuss selected subjects of global relevance in radiology. In 2016, the issue of implementing imaging referral guidelines in clinical routine was analysed. The legal environment in the USA requires that after January 1, 2017, physicians must consult government-approved, evidence-based appropriate-use criteria through a clinical decision support system when ordering advanced diagnostic imaging exams. The ESR and the National Decision Support Company are developing “ESR iGuide“, a clinical decision support system for European imaging referral guidelines using ESR imaging referral guidelines based on ACR Appropriateness Criteria. In many regions of the world, the situation is different and quite diverse, depending on the specific features of health care systems in different countries, but there are, unlike in the USA and EU, no legal obligations to implement imaging referral guidelines into the clinical practice. Imaging referral guidelines and clinical decision support implementation is a complex issue everywhere and the legal environment surrounding it even more so; how they will be implemented into the clinical practice in different areas of the world needs yet to be decided.Main messages• Implementation of imaging referral guidelines in clinical routine is needed.• Potential benefits are improved appropriateness in referrals and reduction of unnecessary radiation exposure.• The educational benefits include new insights through data collection and reporting.• The system will potentially highlight the lack in quality or availability of equipment.
Highlights
The International Forum was established by the European Society of Radiology (ESR) in order to intensify the collaboration of national and international radiological societies from outside Europe and to discuss selected subjects of global relevance in radiology at each European Congress of Radiology (ECR)
Representatives of the following radiological societies, usually the president and one executive member, were invited to this meeting to present the situation in their respective country or region: The American College of Radiology (ACR), the Asian Oceanian Society of Radiology (AOSR), the Canadian Association of Radiology (CAR), the Colombian Association
The ESR and National Decision Support Company (NDSC) are developing “ESR iGuide“, the clinical decision support system for European imaging referral guidelines using ESR imaging referral guidelines based on ACR appropriateness criteria, i.e. the ACR Select system and content [4]
Summary
The International Forum (originally Summit) was established by the European Society of Radiology (ESR) in order to intensify the collaboration of national and international radiological societies from outside Europe and to discuss selected subjects of global relevance in radiology at each European Congress of Radiology (ECR). Reasons for inappropriate imaging are many, and include patients’ expectations and demands for imaging, conflict of interest presented by physician ownership of imaging equipment, incentives for referrals, lack of specific guidance from radiologists and lack of knowledge by referring physicians and other providers and non-physicians In his opinion, family practice physicians frequently order unnecessary tests and as many as 30 % of diagnostic imaging procedures are inappropriate or contribute no useful information. The ESR and NDSC are developing “ESR iGuide“, the clinical decision support system for European imaging referral guidelines using ESR imaging referral guidelines based on ACR appropriateness criteria, i.e. the ACR Select system and content [4]. The system will help to demonstrate the utility of imaging equipment and will potentially highlight a lack in quality or availability
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