American College of Radiology - Appropriateness Criteria

Appropriateness Criteria

During the 1990s, the ACR undertook a massive project to define national guidelines for appropriate use of imaging technologies. The product of this effort is called the ACR Appropriateness Criteria (ACR-AC). The ACRAC were formally introduced during testimony by K.K. Wallace, MD (then chair of ACR Board of Chancellors) to the House Ways and Means Committee in 1993. Dr. Wallace indicated that the ACR stood ready to define a system of patient care guidelines for radiology to eliminate inappropriate utilization of radiologic services (Cascade 1994).

Following appointment of panel chairs in late 1993, the first panelists were selected during early 1994 and by spring, deliberations had begun (Cascade 2000). Ten years later, the ACRAC are the only comprehensive North American practice guidelines for diagnostic imaging selection, radiotherapy protocols, and indications for image guided interventional procedures. They embody the best current evidence for choosing appropriate imaging evaluation and interventional procedures for a large number of clinical conditions.

Further, the ACR has committed to continuously updating the content of these guidelines and has developed the human resources infrastructure to carry this out in the future. By 1999 there were 210 clinicians and scientists serving on 10 panels. These include 35 representatives from 19 specialties other than radiology. The 2000 version contained over 140 clinical conditions with 820 variants. Currently, the ACR website lists over 190 conditions with more than 900 variants.