UPDATED FEBRUARY 1, 2024
In 2022, the ACR Council passed a resolution to make significant changes to the process for developing Practice Parameters and Technical Standards (PP&TS). These changes impact the member commenting period and the annual meeting approval process and will be implemented for PP&TS documents considered during ACR 2024.
The Council’s initial consideration of the PP&TS documents will move from the annual meeting in DC to two virtual meetings March 12 and 14, 2024, from 7–9:30 p.m. Eastern time. Learn more and register for the virtual meetings on the ACR's PP&TS page.
The ACR is changing how it publishes its popular Practice and Technical Standards (PP&TS) guidelines to create a more streamlined experience for members. Established in the early 1990s, the ACR Practice Guidelines and Technical Standards program — renamed in 2014 — was created to help members by providing guidance on the performance and interpretation of various radiological exams.
“PP&TS are documents published by the ACR, sometimes in coordination with other collaborating radiological societies, that serve to help radiologists perform different exams in an appropriate manner agreed on by subject matter experts,” says Derrick R. Siebert, MD, a member of the ACR Council Steering Committee (CSC) and chair of the CSC PP&TS workgroup. “Many of the parameters and standards spell out the components and specifications of each exam in a stepwise and logical fashion.”
The updated PP&TS writing and approval process will incorporate new technologies to decrease the burden on ACR members. The program has instituted two key member-centered initiatives: solicitation of ACR member review and comments after the writing committees have finished their drafts or revisions, and discussion and subsequent approval by ACR members and the CSC during the annual meeting.
The PP&TS process makes documents available online for ACR member comments in the fall, several months prior to the annual meeting. Each May, during the ACR annual meeting, all members may debate the PP&TS content in the reference committee’s open hearings. ACR councilors then vote the following day on approving the documents.
The CSC formed the PP&TS workgroup after leadership noted a desire by members to improve the PP&TS process. Of special concern were claims that councilors did not address member suggestions raised in hearings due to procedural rules and time constraints.
After in-depth examination of the steps leading to PP&TS approval, the workgroup saw the greatest potential for improvement by focusing on two aspects of the document development process: the member commenting period and the annual meeting approval process. In 2022, the ACR CSC approved the workgroup’s recommendations to make significant changes to these two steps. The goal of the updates is to make the process efficient, transparent and more accessible to members, allowing for proposed changes to the documents to be better managed and considered.
The new process will be implemented for PP&TS documents considered during the 2024 and 2025 ACR annual meetings. The first visible process change will be evident to ACR members during the public field review period. Starting this fall, rather than being posted online in four to five groups, each with a three-week comment period, all 2024 documents will be available for comment simultaneously for seven weeks.
“In the past, our members received numerous emails over several months, and the documents they might have wanted to comment on might have already closed while another comment period opened,” says Daniel A. Rodgers, MD, a member of the PP&TS workgroup and a member of the ACR CSC. “Now that's all going to be very standardized.”
The updated process will also move the CSC’s initial consideration of the PP&TS documents from the annual meeting to a virtual meeting scheduled approximately one month prior to the in-person annual meeting.
In the past, our members received numerous emails over several months, and the documents they might have wanted to comment on might have already closed while another comment period opened. Now that's all going to be very standardized.
Rodgers explains why that is significant: “Making the open hearings virtual is going to allow more members to participate — including people who may not be able to go to Washington, D.C., for the annual meeting and members who are not councilors but still want to comment on the PP&TS documents. These changes will open the process to more members and more direct participation, which I think is always great.”
As chair of the CSC PP&TS workgroup, Siebert says the new virtual meeting format will be helpful. “I would say the thing we’re going to most closely mirror is the reference committee open hearings that occur during the annual meeting. Specifically, if people can think back to how things were in 2020 and 2021, when we were virtual, these hearings will be like that, open to all members.”
CSC members were given a chance at ACR 2023 to vote on the format of the new virtual meeting. Members opted to have two evening meetings during the week, each lasting 2½ hours. As a result, the meeting has been scheduled for March 12 and 14 from 7 to 9:30 p.m. ET.
There are numerous ways besides joining the new virtual meeting that ACR members can participate in making the new process as effective as possible.
“You can get involved by discussing the PP&TS with your ACR chapter, so your chapter and your councilor(s) are great points of contact,” says Juan C. Batlle, MD, MBA, a member of the PP&TS workgroup and a member of the ACR CSC. “If you don't want to discuss something yourself, you can give your council member the task by saying, ‘Hey, I have concerns about this. Could you please discuss this at the meeting or during any of these periods and submit things on our behalf?’ And then, finally, submit amendments to the resolution(s). The ACR annual meeting is there to serve the ACR membership. We’d like to have resolutions come in on any subject that is of interest to you and your chapter.”
Mary S. Newell, MD, FACR, chair of the PP&TS Committee, echoes this encouragement for members to get involved. “Member input around these documents is vital and welcome,” she says. “Although the documents have been created by subject experts, I am always interested to see how ‘fresh eyes’ can highlight nuanced issues that should be considered.
“By taking part in the field review, everyone has the opportunity to be those fresh eyes and find points of discussion for the writing committees to deliberate,” Newell says. “The documents can be reviewed in conjunction with other members of your ACR chapter or your specialty society, or by you as an individual, and thus strengthened before ultimate presentation at the virtual meeting. I really encourage people to participate in both field review and the virtual PP&TS review meeting so your suggestions and possible concerns can be noted.”
The initial response to the proposed changes has been positive from members, but there is still work to be done. Members of the PP&TS workgroup are preparing to ramp up promotion of the new process through videos, QR codes and written documents outlining the changes. Additionally, the workgroup plans to make sure members have as many opportunities as possible to provide feedback. They are working to create a forum to allow for comments and questions, as well as encourage ACR members to reach out to workgroup members to allow for consistent communication.
“We want to make sure they know this is a member-driven process, that the reason we're doing this is to make things better for the membership and make things better for the councilors who attend the meetings,” Siebert says. “The PP&TS workgroup are all members, too. We want to make this as effective as we can. We want members to know this is a bottom-up process, not a top-down process.”
The PP&TS workgroup encourages all members with questions, comments or concerns to reach out to ACRPPTS@acr.org to make your voices heard.
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