The indication for imaging is a complex medical decision and there is a need to combine the specifications of the Basic Safety Standards Directive with other recent approaches of medical decision making, especially WHO guidelines on patient safety and on patient adherence Implementation strategies should reflect the role definitions and responsibilities by radiologists or nuclear medicine specialists, shared by referring physicians and patients with radiological technicians and medical physicists to be included if necessary. For clinical use, a checklist approach combined with the physician’s experiences...

The potential benefits of imaging examinations today far outweigh the risks of ionising radiation, and with radiation protection and its holistic approach, many opportunities for improvements in medical imaging can be exploited through this approach. Over the years, these developments were promoted through the Euratom Basic Safety Standards (BSS) Directive, profound concepts on clinical and diagnostic reasoning, a clearer role definition of healthcare professionals and patients, and through WHO recommendations, especially those on patient safety and on adherence. In radiation protection with its holistic approach...

A recommendation for a standard format of referral forms should consist of seven groups of fields to improve the communication between all participants involved in this workflow. In a preliminary setting, the feasibility was tested successfully. Patient demographics Modality and anatomic region Referral diagnosis with attributes (urgency, pretest-probability and pretest specifications, non-medical referrals) Personalisation (previous investigations, underlying diseases) Patient safety (contrast media, radiation safety, magnetic field safety aspects) Patient information (questionnaires etc.) Administration An alert system shall be provided for urgency of the examination, safety...

A structured referral is designed as part of a structured report. Indication is a more comprehensive medical term referring to a purpose-oriented decision basing on a valid reason for using a diagnostic test, a preventive, or a therapeutic measure. The process as a whole and each of its components base on well-elaborated concepts covered under the term diagnostic reasoning. Awareness is needed to apply the concepts of diagnostic reasoning, bioethics, error management, risk competence and the possibilities of computerised decision support in this context. Implementation...

1 Ebdon-Jackson S, Frija G, European Society of R (2021) Improving justification of medical exposures using ionising radiation: considerations and approaches from the European Society of Radiology. Insights Imaging 12:2 2 Commission E (2021) SAMIRA: Strategic Agenda for Medical Ionising Radiation Applications 3 (2014) European Council Directive 2013/59/Euratom on basic safety standards for protection against the dangers arising from exposure to ionising radiation and repealing Directives 89/618/Euratom, 90/ 641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/ Euratom. OJ of the EU L13:1–73 4 Remedios D, Hierath M, Ashford...

F. Kainberger: Nothing to disclose