Europe-wide referral guidelines for medical imaging are essential. Not only do they need to be developed, but their use needs to be improved. 

Lluis Donoso Bach, from Barcelona, Spain talked about the European Society of Radiology's position on clinical decision support at the Management in Radiology session on Saturday at the European Congress of Radiology. Such guidelines must be embedded in a clinical decision support environment, he said. 

A CDS format would have the advantage and flexibility for users to adapt the guidelines to to national, local, institutional or organisational needs.

When the ESR started looking at the issue of guidelines, it looked at the feasibility of merging national guidelines from the only two countries in the EU that have such guidelines, France and the UK. However, discrepancies ruled out this possibility as it would require a large investment of time and effort. 

Now the decision has been taken to adapt the US guidelines, ACR Select, from the National Decision Support Company. The vision is for the ESR iGuide, a European adaptation of ACR Select, with the flexibility for localisation and adaptation.

Donoso Bach emphasised the main benefits - the guidelines would be under the umbrella of the European Society of Radiology. Availability of guidelines would increase their use, reduce unnecessary and inappropriate radiology exams, decrease radiation exposure, improve patient care and clinical workflow and generate data that can be used for research and better decision-making.

This month the ESR plans to sign a Memorandum of understanding with the ACR for adapting the ACR appropriateness criteria with a long term goal of collaborating on a global set of guidelines. 

In Q2 of 2014 the aim is to gain a formal agreement with NDSC on collaboration and on the finances. Adaptation by an expert team is also slated to begin in the second quarter of 2014.

Donoso Bach acknowledged that any guidelines needed to adapt to the reality of the variability in availability of equipment such as MRI. 

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Radiology, Decision Support, ECR2014 Europe-wide referral guidelines for medical imaging are essential. Not only do they need to be developed, but their use needs to be improved. Lluis Don...