Gorbachova Tetyana, Chang Eric Y, Ha Alice S, Amini Behrang, Dorfman Scott R, Fox Michael G, Khurana Bharti, Klitzke Alan, Lee Kenneth S, Mooar Pekka A, Shah Kaushal H, Shah Nehal A, Singer Adam D, Smith Stacy E, Taljanovic Mihra S, Thomas Jonelle M, Kransdorf Mark J
Einstein Medical Center, Philadelphia, Pennsylvania.
Panel Chair, VA San Diego Healthcare System, San Diego, California.
J Am Coll Radiol. 2020 May;17(5S):S2-S11. doi: 10.1016/j.jacr.2020.01.019.
Acute injuries to the foot are frequently encountered in the emergency room and in general practice settings. This publication defines best practices for imaging evaluations for several variants of patients presenting with acute foot trauma. The variants include scenarios when the Ottawa rules can be evaluated, when there are exclusionary criteria, and when suspected pathology is in anatomic areas not addressed by the Ottawa rules. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
足部急性损伤在急诊室和普通医疗环境中经常遇到。本出版物为几种急性足部创伤患者的影像学评估定义了最佳实践。这些变体包括可以评估渥太华规则的情况、存在排除标准的情况以及疑似病变位于渥太华规则未涉及的解剖区域的情况。美国放射学会适宜性标准是针对特定临床情况的循证指南，每年由多学科专家小组进行审查。指南的制定和修订包括对同行评审期刊上的当前医学文献进行广泛分析，并应用成熟的方法（兰德/加州大学洛杉矶分校适宜性方法以及推荐分级评估、制定和评价或GRADE）来评估特定临床场景下影像学和治疗程序的适宜性。在证据缺乏或不明确的情况下，专家意见可能会补充现有证据以推荐影像学检查或治疗。
