ACR Guidelines
The main entity that is providing a comprehensive and ever-changing list of guidelines is the American College of Radiology. With the program referred to as ACR Appropriateness Criteria® (AC), the ACR develops evidence-based appropriateness criteria for a number of imaging techniques and procedures practiced in radiology. The program covers 239 diagnostic imaging and interventional radiology documents, 3,900 clinical scenarios, and more specifications to assist in compliance.
The main focus of these criteria is to aid radiologists in using the most accurate and appropriate imaging tests based upon the given patient’s needs and conditions. Proper adherence to the guidelines is extremely important when ensuring that patients are getting the proper and safest care for them.
Staying Updated on the ACR’s Standards
Like many things in the medical field, the ACR’s guidelines are subject to change. It’s important for radiologists to stay updated on news regarding these updates. You can be sure to stay up to date by referring to these sources:
- ACR Appropriateness Criteria Webpage: ACR’s website is the main source of all of the new updates to the AC. Here you can navigate and filter by topic to see what’s new in a number of different branches.
- ACR News and Press Releases: The news section on the ACR website often announces recent updates or revisions to any of the given guidelines.
- ACR Membership: If you’re a member of the ACR, you can opt in to receive email alerts to be the first notified about updates.
- Follow ACR on Social Media: In our digital age, a great way to stay on top of news is on social media. Follow ACR on Twitter or like them on Facebook to view their new posts in your timeline.
Recently Amended Guidelines in 2024
So far this year, the ACR added six new topics while revising six others. The list of the new topics are:
- Acute Elbow and Forearm Pain
- Endometriosis
- Imaging of Suspected Intracranial Hypotension
- Penetrating Torso Trauma
- Thoracic Back Pain
- Tracheobronchial Disease
The existing topics that were revised by the ACR this year include:
- Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass
- Altered Mental Status, Coma, Delirium, and Psychosis
- Multiple Gestations
- Nonvariceal Upper Gastrointestinal Bleeding
- Pretreatment Staging of Urothelial Cancer
- Stress (Fatigue/Insufficiency) Fracture, Including Sacrum, Excluding Other Vertebrae.
You can read detailed reports about each of these areas on the ACR Homepage.
Challenges with Adapting to Guidelines
It can be hard to always adhere to the guidelines in your practice. Radiologists already have so much information and rules they have to adhere to. So appropriateness criteria may not always be at the forefront of your mind when working with patients. Here are a few potential challenges and ways you can work to overcome them.
- Unfamiliarity of Guidelines: Some radiologists may simply be unaware of the multitude of guidelines that are in the ACR, or their importance. This lack of awareness can lead to incorrect or unnecessary imaging requests which do not align with the recommendations. This can easily be overcome by physicians making an effort to educate themselves and visiting the ACR’s website.
- Time Constraints: A work day for a radiologist can be jam-packed with patients, not giving time for doctors to scroll through the guidelines trying to find the exact topic they need information on. The implementation of a Clinical Decision Support System (CDSS) within EHR systems can automate relevant ACR criteria during an imaging request. This saves time and gets radiologists the information they need without lifting a finger.
- Balance of Guidelines with Clinical Judgment: While the ACR’s guidelines are evidence-based, they cannot possibly account for every individual patient’s situations. This may occasionally lead to doctors deviating from the guidelines in order to provide tailored care that best suits the unique needs and circumstances of their patients.
There are often situations that are out of a physician’s control. The best they can do in those given times is reevaluate and tackle the problem at hand, sticking to the guidelines as best as they can.
Implementing The Guidelines in Your Practice
The guidelines curated by the ACR are more than just a set of ethical rules for radiologists, but they are the parameters that need to be in place in order for patients to get the best treatment and to get healthier, faster.
The AC recommends that doctors are sure to consider a patient’s symptoms and medical history before going ahead with a treatment. These are factors that can be extremely important when considering what treatment a patient should receive. Failure to check these factors (and more) can result in wasted time, improper treatment, among other negative results.
By following the guidelines, radiologists are able to ensure a more cost-effective treatment for the patient and hopefully less testing overall. If the proper procedure is used from the start, thanks to the AC’s guidance, then time, money, and health can be conserved, promoting efficiency and patient well-being.