In support of the ACR Appropriateness Criteria.

The American College of Radiology Appropriateness Criteria were recently revised and translated into a new electronic format searchable online. They are also now being used as the basis for decision support logic underlying computerized radiology order entry. This article addresses some previous criticisms of the structure and output of the American College of Radiology expert panel process. Although there is certainly room for improvement, the conceptual framework and methodology underlying the appropriateness criteria are sound and do not need to be drastically altered.

[1]  J. Tobacman,et al.  Comparison of Appropriateness Ratings for Cataract Surgery between Convened and Mail-only Multidisciplinary Panels , 2001, Medical decision making : an international journal of the Society for Medical Decision Making.

[2]  P. Shekelle,et al.  Effect of patient-specific ratings vs conventional guidelines on investigation decisions in angina: Appropriateness of Referral and Investigation in Angina (ARIA) Trial. , 2007, Archives of internal medicine.

[3]  B. Burnand,et al.  The RAND/UCLA Appropriateness Method User's Manual , 2001 .

[4]  J. Tobacman,et al.  Visual Acuity following Cataract Surgeries in Relation to Preoperative Appropriateness Ratings , 2003, Medical decision making : an international journal of the Society for Medical Decision Making.

[5]  R. Kravitz,et al.  Validity of criteria used for detecting underuse of coronary revascularization. , 1995, JAMA.

[6]  N. Black,et al.  An experimental study of determinants of group judgments in clinical guideline development , 2004, The Lancet.

[7]  R. Brook,et al.  Appropriateness of Care: A Comparison of Global and Outcome Methods to Set Standards , 1992 .

[8]  L. S. Medina,et al.  Evidence-based radiology and the ACR Appropriateness Criteria. , 2006, Journal of the American College of Radiology : JACR.

[9]  A. Gittelsohn,et al.  Small Area Variations in Health Care Delivery , 1973, Science.

[10]  Johnathan L Hadley,et al.  Potential impact of the American College of Radiology appropriateness criteria on CT for trauma. , 2006, AJR. American journal of roentgenology.

[11]  J R Thornbury,et al.  Technology assessment--an American view. , 1992, European journal of radiology.

[12]  G Samsa,et al.  Global Judgments versus Decision-model-facilitated Judgments , 1994, Medical decision making : an international journal of the Society for Medical Decision Making.

[13]  A. P. Meijler,et al.  Setting standards for effectiveness: a comparison of expert panels and decision analysis. , 1997, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[14]  P. Shekelle The Appropriateness Method , 2004, Medical decision making : an international journal of the Society for Medical Decision Making.

[15]  P Paul-Shaheen,et al.  Small area analysis: a review and analysis of the North American literature. , 1987, Journal of health politics, policy and law.

[16]  C. Sistrom,et al.  The ACR appropriateness criteria: translation to practice and research. , 2005, Journal of the American College of Radiology : JACR.

[17]  I. Arostegui,et al.  Health-related quality of life and appropriateness of knee or hip joint replacement. , 2006, Archives of internal medicine.

[18]  Janice C. Honeyman-Buck,et al.  Relational Data Model for the American College of Radiology Appropriateness Criteria , 2002, Journal of Digital Imaging.

[19]  Dennis G. Fryback,et al.  The Efficacy of Diagnostic Imaging , 1991, Medical decision making : an international journal of the Society for Medical Decision Making.

[20]  R. Brook,et al.  Appropriateness of upper gastrointestinal endoscopy: comparison of American and Swiss criteria. , 1997, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[21]  A. P. Meijler,et al.  Panellist consistency in the assessment of medical appropriateness. , 1996, Health policy.

[22]  J. Sosna,et al.  Preauthorization of CT and MRI examinations: assessment of a managed care preauthorization program based on the ACR Appropriateness Criteria and the Royal College of Radiology guidelines. , 2006, Journal of the American College of Radiology : JACR.

[23]  R. Brook,et al.  Appropriateness of Care , 1989 .

[24]  R. Brook,et al.  Consensus methods: characteristics and guidelines for use. , 1984, American journal of public health.

[25]  L. S. Medina,et al.  Evidence-Based Imaging: Optimizing Imaging in Patient Care , 2007, Journal of Nuclear Medicine.

[26]  P G Shekelle,et al.  Are nonspecific practice guidelines potentially harmful? A randomized comparison of the effect of nonspecific versus specific guidelines on physician decision making. , 2000, Health services research.

[27]  R H Brook,et al.  A Method for the Detailed Assessment of the Appropriateness of Medical Technologies , 1986, International Journal of Technology Assessment in Health Care.

[28]  P. Shekelle,et al.  Assessing the Predictive Validity of the RAND/UCLA Appropriateness Method Criteria for Performing Carotid Endarterectomy , 1998, International Journal of Technology Assessment in Health Care.

[29]  R H Brook,et al.  Does inappropriate use explain small-area variations in the use of health care services? , 1990, JAMA.

[30]  L Goldman,et al.  Expert panel vs decision-analysis recommendations for postdischarge coronary angiography after myocardial infarction. , 1999, JAMA.

[31]  J P Kahan,et al.  The reproducibility of a method to identify the overuse and underuse of medical procedures. , 1998, The New England journal of medicine.

[32]  B. Burnand,et al.  Appropriateness of Surgery for Sciatica: Reliability of Guidelines From Expert Panels , 2000, Spine.

[33]  B J McNeil,et al.  Rating the appropriateness of coronary angiography--do practicing physicians agree with an expert panel and with each other? , 1998, The New England journal of medicine.

[34]  R. Kravitz,et al.  Measuring the clinical consistency of panelists' appropriateness ratings: the case of coronary artery bypass surgery. , 1997, Health policy.

[35]  R H Brook,et al.  Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures. , 1987, JAMA.

[36]  M. Degroot Reaching a Consensus , 1974 .

[37]  D. Brenner,et al.  Computed tomography--an increasing source of radiation exposure. , 2007, The New England journal of medicine.

[38]  P. Shekelle,et al.  Impact of varying panel membership on ratings of appropriateness in consensus panels: a comparison of a multi- and single disciplinary panel. , 1995, Health services research.

[39]  Liav Goldstein,et al.  Nonradiologist utilization of American College of Radiology Appropriateness Criteria in a preauthorization center for MRI requests: applicability and effects. , 2006, AJR. American journal of roentgenology.

[40]  D. Ballard,et al.  Eight recommendations for maximizing the return on investment in external quality oversight. , 1997, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[41]  C E Kahn,et al.  Applicability of American College of Radiology appropriateness criteria in a general internal medicine clinic. , 1999, AJR. American journal of roentgenology.

[42]  M. Bettmann The ACR Appropriateness Criteria: view from the committee chair. , 2006, Journal of the American College of Radiology : JACR.