The Role of the ACR Appropriateness Criteria in the Medical Literature

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The most recent ACR Appropriateness Criteria (AC) supplement contains 17 new or revised topics and augments the total number of citable AC publications. These topics come from 9 of the 11 AC specialty areas and build the comprehensive body of diagnostic imaging literature. A recent review by the College found that roughly one-third of all visits to the ACR website go to an AC document. With more awareness of the AC fostered by journal publications, my hope is that AC documents become routinely cited throughout the radiology literature, and beyond. The AC program has made important advances over the last 6 months. First, based on a concept that originated with the leadership of JACR, Bruce Hillman, MD, editor-in-chief, and Andrea Borondy Kitts, MS, MPH, associate editor, have spearheaded the creation of patient-friendly summaries of the AC documents. A number of these documents have already been published. After this, the AC created the Patient Engagement Subcommittee and appointed Jennifer Uyeda, MD, as chair. An editorial describing the committee’s activities has been published [1Uyeda J.W. Kitts A.B. Rybicki F.J. The ACR Appropriateness Criteria Patient Engagement Subcommittee.J Am Coll Radiol. 2018; (Available at:)https://doi.org/10.1016/j.jacr.2018.03.038PubMed Google Scholar]. Developing and supporting patient advocacy input expands the AC program’s scope. Third, we have forged new relationships with cardiovascular societies—namely, the Society of Cardiovascular Computed Tomography and the Society of Cardiovascular Magnetic Resonance—to augment the clinical expertise within the AC for our cardiac and vascular groups. Finally, we added AC subspecialty panels to provide a more expansive collection of AC documents that ordering providers demand. Future efforts will focus on reducing time required to review and incorporate the relevant medical developments into our recommendations. Although the AC represents the largest body of evidence-based recommendations for diagnostic imaging, ACR is not the only entity developing appropriate use criteria. To meet the challenges of the dynamic appropriate use criteria development milieu, two additional committees, the Rapid Response Committee (RRC) led by Michael A. Bettmann, MD, and the Gaps and Harmonization Committee (GAHC) led by E. Kent Yucel, MD, were formed. The RRC addresses the users’ needs and questions by providing clarification of the clinical decision support mechanism that delivers AC content, creating localized rules, and facilitating communication between the marketplace and ACR. The GAHC uses the feedback from the RRC to determine gaps in AC content and harmonize AC content with other societies’ guidance, and the GAHC works with the AC Committee to prioritize content development. Future work will include analyses of the contributions from medical professionals that influence radiology practice. The ACR Appropriateness Criteria® Patient Engagement SubcommitteeJournal of the American College of RadiologyVol. 16Issue 3PreviewPatient- and family-centered care (PFCC) is defined as “a model of providing care in which the patient and family are partners with the provider and care team” [1-3]. The role of the radiologist in PFCC can be challenging since our direct contact with patients is often limited. Patient satisfaction and outcomes are increasingly being associated with quality medical care and also with reimbursement as alternative payment models are introduced. Imaging is essential for screening, diagnosis, and therapy monitoring. Full-Text PDF