A concerted effort to eliminate unnecessary medical procedures is underway across America, and radiology experts are taking a lead role.
One such initiative is the Choosing Wisely campaign by the ABIM Foundation. Choosing Wisely outlines five goals aimed at eliminating over-utilization and increasing communication between physicians.
Choosing Wisely
“We’re all trying to do the right thing for patients, and we all understand the need to cost-set healthcare,” said Chad Calendine, MD, of Nashville-based Premier Radiology. “As radiologists, we evaluate orders and procedures when they come in and often talk to physicians about changing orders to make sure the appropriate test is being ordered.”
The Choosing Wisely campaign’s imaging goals, which were developed by the American College of Radiology, include:
Don’t image uncomplicated headaches.
Don’t image for suspected pulmonary embolism without moderate or high pre-test probability.
Avoid admission or preoperative chest x-rays for ambulatory patients with unremarkable history and physical exam.
Don’t perform CT for the evaluation of suspected appendicitis in children until after ultrasound has been considered as an option.
Don’t recommend follow-up imaging for clinically inconsequential adnexal cysts.
“We only want to use radiation if it’s needed, and if the benefits far outweigh potential risks,” Calendine said. “Having an eye toward reduction is at the heart of what radiologists have done for decades.”
Image Wisely
Similarly, Image Wisely is the joint awareness campaign of the ACR and Radiological Society of North America to address concerns about the surge of public exposure to ionizing radiation from medical imaging. A joint task force collaborated with the American Association of Physicists in Medicine and the American Society of Radiologic Technologists to create the campaign aimed at lowering radiation doses and procedures in adult patients. Image Wisely provides extensive educational resources including up-to-date research and radiation news, and asks radiology professionals to take a pledge to honor their commitment to safer standards.
Image Gently
Image Gently is an initiative aimed at pediatric imaging awareness. With a motto of ‘one size does not fit all,’ the campaign hones in on appropriate medical and dental imaging for young patients. Radiology Alliance’s Ketsia Pierre, MD, who specializes in diagnostic and pediatric radiology, said a primary goal is to use ultrasound instead of CT for abdominal pain in peds patients.
“There’s been ongoing training of sonographers to become more skilled in scanning for acute appendicitis … and in most cases, they’re so good that we’re rarely using CT to evaluate for appendicitis,” Pierre said. “When CT is necessary, one of the Image Gently principles is limiting the field of use to the area where the appendix lives and lowering the dose, as well.”
Pierre estimates she now spends up to 25 percent of her day on the phone educating physicians about the latest recommendations surrounding risk vs. benefit of various imaging options.
“There always needs to be an open line of communication between radiologists and physicians caring for patients, and we’re happy to talk them,” she said.
Save the Date
The Vanderbilt University Institute of Imaging Science (VUIIS) will host the Frontiers of Medical Imaging V Conference May 12-15, 2015.
The conference will bring together researchers from various sub-fields of imaging sciences to review the state-of-the-art technology and potential breakthroughs in an informal venue. Themes for Frontiers V will include:
Metabolic Imaging,
Imaging and Aging,
Imaging Technologies,
Nanotechnology in Imaging,
Image Guided Interventions,
Young Investigators Symposium.
VUIIS pursues research in developing new imaging methods and applications in cancer, neuroscience, metabolic disorders, cardiovascular disease and other areas. The Institute also supports advances in physics, engineering, computing, chemistry and other sciences for the development and application of new and improved imaging techniques.
Email tracy.wilson@vanderbilt.edu for more information.
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