Appropriate imaging requires justification of the procedure requested and consideration of the best test first which will answer the clinical question asked. Imaging investigations are not always required for management of a clinical problem and yet often requests are made for low value imaging, resulting in over-utilisation of diagnostics, over-diagnosis and over-treatment. Besides the waste of imaging resource and expertise, there are radiation safety and economic considerations which are as important to low income countries as they are to higher income countries. This study seeks...
Description of activity and work performed
The most common clinical scenarios requiring imaging guidance were correlated amongst national Choosing Wisely campaigns in Australia, Canada, UK and USA; national priority areas in the USA; and UK iRefer Guidelines web hits. Message mapping was used to provide concise but precise guidance for appropriate use of imaging in such clinical situations in a format which could be used in a poster, leaflet or on-line web page.
The 10 most common clinical scenarios common to multiple sources which would benefit from image referral guidance are:...
Conclusion and recommendations
Conclusions: The commonality of clinical problems needing imaging guidance globally enables a focussed approach to the top 10 areas for appropriate imaging encouraging effective, safe and valuable diagnostics in any country.
D. Remedios; Harrow/UK - nothing to disclose
J. Kasznia-Brown; Taunton/UK - nothing to disclose
1.The Royal College of Radiologists. RCR iRefer Guidelines: Making the best use of clinical radiology. London: The Royal College of Radiologists, 2017. https://www.irefer.org.uk/
2.Choosing Wisely Australia. http://www.choosingwisely.org.au/recommendations
3.Choosing Wisely Canada http://www.choosingwiselycanada.org/recommendations/radiology/
4.Choosing Wisely UK http://www.choosingwisely.co.uk/i-am-a-clinician/recommendations/
5.Choosing Wisely USA. http://www.choosingwisely.org/societies/american-college-of-radiology/
6.Lacson R, Khorasani R et al. Medicare Imaging Demonstration: Assessing Attributes of Appropriate Use Criteria and Their Influence on Ordering Behavior. AJR 2017; 208:1051–1057. DOI:10.2214/AJR.16.17169 https://www.ncbi.nlm.nih.gov/pubmed/28267371
7.Hentel K, Menard A, Khorasani R. New CMS Clinical Decision Support Regulations. Radiology 2017; 283:10–13. http://pubs.rsna.org/doi/full/10.1148/radiol.2017161560
8.Message Mapping. http://rcfp.pbworks.com/f/MessageMapping.pdf