Senior Director of Guidelines Development, American College of Radiology, Reston, Virginia.
Riley Hospital for Children, Indiana University, Indianapolis, Indiana.
J Am Coll Radiol. 2021 Nov;18(11S):S240-S250. doi: 10.1016/j.jacr.2021.03.021. Epub 2021 Jul 9.
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. The ACR is recognized as a qualified provider-led entity by CMS for the development of appropriate use criteria. This paper describes the methodology and illustrates adherence to the process in the development of the AC.
ACR 适宜性标准®（AC）是基于证据的指南，指导医生进行适当的影像检查。AC 的制定和修订过程遵循透明的方法，包括对同行评议期刊上的现有医学文献进行系统分析，并应用成熟的指南标准（美国医学研究所的“我们可以信赖的临床实践指南”）和方法（RAND/UCLA 适宜性方法和推荐评估、制定和评估分级）来评估特定临床情况下影像学和治疗程序的益处和潜在风险，或适宜性。在 2020 年 10 月的发布中，该方法应用于 198 份涵盖 1760 个临床情况的 AC 文件的开发中，提出了 8815 多条建议，由代表多个专业学会的 600 多名成员撰写，并使用了 6200 多条参考文献。ACR 被 CMS 认可为合格的以提供者为主导的实体，负责制定适宜使用标准。本文描述了该方法，并说明了在 AC 制定过程中对该方法的遵守情况。
