ACR Announces Update to ACR Appropriateness Criteria™


For more than a decade, the ACR Appropriateness CriteriaTM has been recognized as the benchmark for the proper use of radiologic services, with more than 170 topics with 700 variants and participation from more than a dozen medical specialty societies. The past year saw a tremendous increase in the interest for the Appropriateness CriteriaTM from payers and other third-parties, further establishing it as the professional point of reference.

Yet, just as radiology is constantly changing, the Appropriateness CriteriaTM is changing as well to keep up with trends and developments in the field, reflecting the ACR's continuing commitment to providing radiologists and referring providers with up-to-date information.

A new version of the Appropriateness CriteriaTM was released this summer after an exhaustive review and revision. The updated version includes many new features such as:

  • A revised format
  • At least 50 updated topics
  • A user-friendly search engine that allows for searches by either a condition or a procedure, providing for quicker access to critical information

"We are committed to promoting the Appropriateness CriteriaTM and keeping it current and credible," says ACR Fellow Michael A. Bettmann, MD, chair of the ACR's Appropriateness Criteria Committee. "This is an opportunity for the ACR, with the support of other specialties, to provide input and guidance on the appropriate use of imaging services."

More Updates, Revisions Coming Soon

These revisions, however, are not the end of the updated Appropriateness CriteriaTM. In fact, plans call for most of the remaining topics to be updated by the end of the year, with another release before the end of 2005; future revisions will be released semiannually thereafter. Coming later this year, a PDA format also will be available to improve portability.

There has been a small pilot project to determine the usefulness and level of interest in a pocket guide format of the Appropriateness CriteriaTM, with a larger similar pilot planned in conjunction with primary care and radiology residency programs at 2 institutions to gain resident input on that format.

"Efforts are ongoing to convert the Appropriateness CriteriaTM into a more user-friendly format so that it can be easily incorporated into other systems," Bettmann notes. "A relational database currently is being tested, and the feedback we receive will help us define the program's direction for the future."

Industry Interest in the Appropriateness Criteria on the Rise

Interest in the ACR Appropriateness CriteriaTM increased significantly during the past year as several of the nation's leading third-party payers and other entities announced plans to utilize the Appropriateness CriteriaTM. Last December, UnitedHealthcare announced it would support the use of the criteria among its more than 400,000 health care providers. This past June, Medicalis Corporation, a software vendor, followed suit and has incorporated the Appropriateness CriteriaTM into its clinical decision-support database. Many of the nation's leading Blue Cross affiliates, as well as other payers, have also indicated similar plans. Several of the country's leading software vendors have expressed an interest in incorporating the criteria into their decision-support software.

As before, there is no charge for individual users of the Appropriateness CriteriaTM. However, given the increased interest in the criteria from outside parties, the ACR's leadership is exploring different strategies for handling requests from facilities, vendors, payers, and other parties who are interested in using the Appropriateness CriteriaTM on a broader scale. These options may include licensing agreements and fees to protect the College's intellectual property and provide the College with the necessary financial resources to keep the Appropriateness CriteriaTM up-to-date and readily available to radiologists.

"These are exciting times for the College as we develop a clear focus on appropriate utilization as the road to improved patient care," Bettmann says. "The ACR Appropriateness CriteriaTM program will play a strong role in forwarding this aim."

The ACR Appropriateness CriteriaTM is available on the ACR's Web site at www.acr.org. If you have questions regarding the ACR Appropriateness CriteriaTM please contact Christine Waldrip at (800) 227-5463, ext 4793, or at christinew@acr.org.