Helping Laypeople Understand Appropriate Medical Imaging
The first patient-friendly summary of the American College of Radiology Appropriateness Criteria was published online in JACR.
With the advent of new imaging technologies and increasing use of medical imaging for screening and diagnosis, it can be confusing for those of us without a medical background to know the right imaging test for a given situation. Many of us know that radiation exposure is a risk of some imaging tests, but we don't always know how much radiation we receive from a given exam or if there are alternative tests. It can be difficult to decipher this type of information using "Dr. Google." Additionally, referring providers are sometime unsure as well and may find it difficult to turn a patient down who insists on a given imaging test based on non-credible information. For example, a patient may ask for an MRI for an initial acute onset of lower back pain without symptoms concerning for malignancy or neurological issues.
The American College of Radiology (ACR) Appropriateness Criteria (AC) are guidelines for appropriate imaging tests and treatment based on patient symptoms, medical histories, and health status. The guidelines are written and reviewed by an expert panel of people from different medical specialties. There are currently 237 ACs. JACR started publishing ACs in May 2017. The ACs are published and made freely available online as they are updated as part of the ACR AC review and update cycle.
These are excellent resources for medical professionals but not readily understandable by laypeople. The JACR editorial team thought the suggestion to provide a 250-word patient-friendly summary for each AC was a great idea. It would be a way to help patients, referring physicians, and even radiologists to understand and explain appropriate imaging tests to laypeople. The rationale behind the project was that helping patients understand appropriate imaging may help them better understand why their doctors don't order a test, to question the requirement for an expensive test, better understand test results and limitation, and to improve commitment to undergoing the imaging test.
The JACR staff enthusiastically helped define the process for drafting, review, and publication of the abstracts. We decided we would recruit layperson and patient advocate authors to draft the abstracts. The ACR AC Committee embraced the project as a perfect way to kick off the newly formed AC Patient Engagement Subcommittee led by Jennifer Uyeda, MD.
The first patient-friendly Appropriateness Criteria summary was recently published online. We have published two so far and have another six ready to go. Our goal is to publish at least ten more (for a total of 18) by May 2018.