Derrick Siebert, MD, Member of the American College of Radiology® (ACR®) Council Steering Committee (CSC) and Chair of the CSC Practice Parameters and Technical Standards (PP&TS) Workgroup, contributed this piece.
The ACR Council approved a resolution at the 2022 annual meeting which changes the way PP&TS are edited and reviewed. Due to the lead time needed for the writing and commenting for the PP&TS process, the new method of approval could not be implemented until the 2024 cycle. We are currently in the lead-up to that cycle, and many of the new procedures are already being used!
While we look forward to seeing the new process fully implemented, it is also useful to look back and remember why this was developed. Practice parameters and technical standards are some of the most important documents published by the ACR. Formerly called the clinical guidelines, the practice parameters and technical standards give practicing radiologists, radiation oncologists and medical physicists access to some of the best subject matter experts their fields have to offer. These documents are a consensus agreement on many different topics in radiology, including: how to perform various examinations, what images or series to acquire, what risks to discuss with patients, what complications may occur and how to treat them, and many other important topics relevant to the daily practice of radiology. While these documents are a quick resource to consult, writing them and coming to a consensus on their content isn’t always a fast process.
Many ACR members will remember lengthy discussions on specific PP&TS at the annual meeting. Oftentimes these discussions would continue late into the day and may even delay other events. The workgroup tasked with improving the PP&TS process focused on the necessity of these conversations but recognized there were many earlier steps in the writing and editing process where these conversations should be taking place. We asked members to explain their understanding of the process and list reasons why participation was not occurring earlier.
One of the things we found was confusion on the appropriate time to comment. The workgroup recommended consolidating the public comment period for all PP&TS into one time, formerly four separate times. We are nearing the end of that public comment period, and it will be interesting to see if the number of comments has changed. Member feedback on the ease of commenting and knowledge that they can read and comment on all PP&TS up for renewal simultaneously will also be valuable.
After public comment ends, the reconciliation committees will begin to meet. Their job, with the writing committee, will be to incorporate the public comments into the PP&TS, where appropriate. That version will then come to the ACR Council for discussion and approval, which is the second step that will be changing, but that’s a story for a little bit later!
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