ACR-RADS Programs Current State and Future Opportunities: Defining a Governance Structure to Enable Sustained Success.

In the spring of 2021, the ACR approved a proposal to improve the consistency, transparency, and administrative oversight of the ACR Reporting and Data Systems (RADS). A working group of experts and stakeholders was convened to draft this governance document. Major advances include (1) forming a RADS Steering Committee, (2) establishing minimum requirements and evidence standards for new and existing RADS, and (3) outlining a governance structure and communication strategy for RADS.

ACR Appropriateness Criteria® Methodology.

The ACR Appropriateness Criteria® (AC) are evidence-based guidelines that guide physicians on appropriate image ordering. The AC development and revision process follows a transparent methodology that includes the systematic analysis of current medical literature from peer-reviewed journals and the application of well-established guidelines standards (the Institute of Medicine's Clinical Practice Guidelines We Can Trust) and methodologies (the RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development and Evaluation) to rate the benefits and potential risks, or appropriateness, of imaging and treatment procedures for specific clinical scenarios. In the October 2020 release, the methodology is applied in the development of 198 AC documents covering 1,760 clinical scenarios to make more than 8,815 recommendations, authored by more than 600 members representing multiple expert societies, and using more than 6,200 references.

A Secondary Analysis to Identify Patient-Centered Outcomes in the ACR's Appropriateness Criteria.

Context: There is a growing body of literature indicating imaging testing can affect patients cognitively, socially, behaviorally, and emotionally. The extent to which these patient-centered outcomes (PCOs) are reported in the imaging literature is unclear. Identifying PCOs may facilitate shared decision making around imaging testing.

Clinical decision support: the role of ACR Appropriateness Criteria.

Clinical decision support is a way to decrease inappropriate imaging exams and promote judicious use of imaging resources. The adoption of clinical decision support will be incentivized by requiring the use of approved mechanisms to qualify for Medicare reimbursement starting in January 2020. Insurance providers base their reimbursement policies on Medicare, so clinical decision support could soon become relevant to pediatric imaging.