Department of Radiology, Stanford University School of Medicine, Stanford, CA.
Department of Radiology, Baylor College of Medicine, Houston, TX.
Curr Probl Diagn Radiol. 2021 Nov-Dec;50(6):774-778. doi: 10.1067/j.cpradiol.2020.10.017. Epub 2020 Nov 16.
The aim is to present our long-term institutional experience on the use of the American College of Radiology's (ACR's) Radiology Support, Communication, and Alignment Network (R-SCAN) via educational presentations and guideline dissemination in sustaining lumbar spine magnetic resonance imaging (MRI) appropriateness for low back pain.
Initial educational presentations on appropriate use criteria for lumbar spine MRI were given to referring providers at three county clinics in April and May of 2016. A second educational refresher was given to the same 3 clinics in November 2017: Clinic A received guideline dissemination, Clinic B served as a control group, and Clinic C received a refresher presentation. Wilcoxon rank-sum test was used to compare the monthly MRI referral rate and ACR Appropriateness Criteria rating.
There was no significant difference in monthly referral rates and ACR Appropriateness Criteria after the second education. Monthly referral rates were significantly lower than the baseline rates before the first education for Clinic A (P <0.001), C (P = 0.004), and the combined total (P = 0.002). ACR Appropriateness Criteria ratings were significantly higher than the baseline ratings before the first education for Clinic C (P = 0.002) and the combined total (P = 0.024).
After the second education, inappropriateness, and referral rates remained significantly lower when compared to rates before but not after the first education. Radiology Support, Communication, and Alignment Network is an invaluable online tool for both radiology practices and referring clinicians to become familiar in preparing to comply with the Protecting Access to Medicare Act and satisfying the Improvement Activities category of the Merit Based Incentive Payment Systems.
本研究旨在通过教育讲座和指南传播，介绍美国放射学院（ACR）放射科支持、沟通和调整网络（R-SCAN）在维持腰椎磁共振成像（MRI）用于腰痛的适宜性方面的长期机构经验。
2016 年 4 月和 5 月，在三个县诊所向转诊医生进行了腰椎 MRI 适宜性标准的初始教育讲座。2017 年 11 月，对这 3 个诊所进行了第二次教育更新：诊所 A 接受了指南传播，诊所 B 作为对照组，诊所 C 接受了更新讲座。采用 Wilcoxon 秩和检验比较每月 MRI 转诊率和 ACR 适宜性标准评分。
第二次教育后，每月转诊率和 ACR 适宜性标准评分无显著差异。与第一次教育前的基线相比，诊所 A（P <0.001）、C（P=0.004）和总诊所（P=0.002）的每月转诊率显著降低。与第一次教育前的基线相比，诊所 C（P=0.002）和总诊所（P=0.024）的 ACR 适宜性标准评分显著升高。
与第一次教育后的转诊率相比，第二次教育后，不适当和转诊率仍然显著降低。放射科支持、沟通和调整网络是放射科实践和转诊临床医生的宝贵在线工具，有助于熟悉准备遵守《保护医疗保险法案》和满足基于绩效的激励支付系统的改进活动类别。
