March 09, 2018

New Vehicle for Feedback on ACR Appropriateness Criteria

We have launched a new web tool to better track and manage feedback on ACR Appropriateness Criteria® (AC) from a variety of sources. The latest release of the AC includes 176 diagnostic imaging and interventional radiology topics with 883 clinical variants and over 1,570 clinical scenarios.

The feedback tool allows anyone — from patients to physicians and from ACR members to nonmembers — to easily find new and revised AC topics available for formal external review as well as existing AC topics available for public commenting.

The feedback tool will better enable staff to organize, review, document and track feedback, with the goal of allowing users see how their comments were addressed. The site will be more accessible to the general public and to those external to the ACR and the formal AC process. The feedback link on the AC website is available to provide additional access to the commenting process.

The Importance of Public Comment

Allowing public commenting is one of the standards for developing “trustworthy guidelines.” In June 2016, CMS named the ACR a qualified Provider-Led Entity (qPLE), approved to provide appropriate use criteria (AUC) for advanced diagnostic imaging under the Medicare Appropriate Use Criteria program. This means that medical providers and approved clinical decision support mechanisms can use the AC to fulfill the Protecting Access to Medicare Act (PAMA) legislation that requires providers to consult AUCs prior to ordering advanced diagnostic imaging for Medicare patients.

It is important for the ACR to have a transparent process for stakeholders to review ACs as a CMS-approved qPLE under PAMA. This new tool enhances the functionality and tracking of AC reviews and feedback.

Principles for Feedback

External review and public commenting are an integral part of the feedback process for new releases of AC. Feel free to visit the review site, review the topics you are interested in and provide your thoughts and suggestions. A few principles for providing feedback include:

  • You should only use Internet Explorer as your browser. Later, additional web browsers will be added to support the site.
  • We required you to create a login with a valid email address so we can respond to your comment/feedback or ask for additional clarification. Registering will also allow us to inform you when additional content is available.
  • We ask that users complete a few demographic facts in a user profile so we can determine if we are reaching all appropriate stakeholders, especially those external to the AC process. This information is not shared with third parties.
  • Comments and feedback will be collated and reviewed by staff and the expert panels at appropriate times in the AC development or revision process.
  • Feedback can be provided at any time via the public comment tool, but the public commenting period is open up to two months after the notification of the release. This timeframe allows us to capture your input and include it in the topic review.

We encourage you to share the link to the AC public commenting tool with your colleagues and ask them to review the documents and comment, as appropriate.

After we release new and revised AC topics, we will email those who have signed up for notifications so they can review the topic content. This feature will be available in a subsequent upgrade to the site. Typically, ACR releases new and revised topics twice a year, around April and November.

Please let us know if you have any suggestions for the review tool so we can collect and address better your input and comments. Learn more at