Clinical Scorecard: Effects of Imaging Referral Guidelines on Patient Outcomes and Radiology Services: A Systematic Review
At a Glance
Category
Detail
Condition
Overuse and low-value diagnostic imaging
Key Mechanisms
Implementation of evidence-based imaging referral guidelines to optimize imaging appropriateness and reduce low-value imaging
Target Population
Adult and paediatric patients undergoing diagnostic imaging
Care Setting
Primarily in-hospital imaging settings including emergency departments and outpatient clinics
Key Highlights
Low-value imaging procedures range widely from 2% to ≥90% globally, contributing to inefficient healthcare resource use.
Evidence-based imaging referral guidelines (e.g., ACR Appropriateness Criteria®, ESR iGuide, RCR iRefer) are endorsed internationally but implementation varies.
Use of imaging referral guidelines aims to improve appropriateness of imaging, reduce unnecessary radiation exposure, and support value-based radiology.
Guideline-Based Recommendations
Diagnosis
Apply evidence-based imaging referral guidelines to determine the appropriateness of diagnostic imaging requests.
Management
Incorporate imaging referral guidelines as decision-support tools to reduce low-value imaging and optimize resource use.
Monitoring & Follow-up
Track imaging volume, appropriateness ratings, and decision support scores to evaluate guideline impact.
Risks
Excessive low-value imaging leads to inefficient resource allocation and potential patient harm from unnecessary radiation exposure.
Patient & Prescribing Data
Studies included adult outpatients, emergency department patients, paediatric patients, and inpatients across multiple countries.
Implementation of referral guidelines is associated with changes in imaging volume and appropriateness, though global appropriateness remains suboptimal.
Clinical Best Practices
Adopt internationally recognized evidence-based imaging referral guidelines tailored to local healthcare settings.
Engage multi-institutional collaboration to standardize imaging referral practices and improve guideline adherence.
Continuously evaluate imaging appropriateness and resource utilization to support value-based radiology initiatives.
