High-Tech Imaging Toolkit
The Minnesota Medical Association has created a list of resources to help physicians move toward the use of evidence-based decision support tools when ordering high-technology imaging procedures for patients.
When health plans in early 2007 introduced requirements that physicians obtain prior authorization from a third-party vendor before ordering high-tech imaging procedures such as CT, MRI and PET scans, the MMA asked health plans to withdraw these programs, and instead urged support for a community-wide effort to collect information that will result in a clear understanding of high-tech imaging use throughout Minnesota.
The MMA is committed to evidence-based medical practice and encourages physicians to evaluate and consider the implementation of decision support tools for imaging services as a way to ensure high quality care.
To help Minnesota physicians understand the evidence-based decision support tools available, the MMA has compiled an "Imaging Toolkit," which includes evidence-based guidelines, decision support tools, and physician education and quality improvement resources.
Links are provided below. Note that these are external links; the MMA cannot guarantee information on external links. Additionally, some links may require a subscription.
Appropriateness Criteria and Evidence-based Guidelines
Appropriateness Criteria
The ACR Appropriateness Criteria®
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision
The American College of Cardiology Foundation (ACCF)
Appropriateness Criteria and e-toolkit
Along with key specialty and subspecialty societies, the American College of Cardiology Foundation has developed Appropriateness Criteria. Link to clinical e-toolkit www.acc.org/qualityandscience/clinical/ekit_appropriateness.htm
Evidence-Based Guideline Resources
British Medical Journal
A monthly review of evidence of the effects of common clinical interventions
Cochrane Reviews
Published on a quarterly basis, the Cochrane Review consists of a regularly updated collection of evidence-based medicine databases providing information to people who provide and receive care and those responsible for research, teaching, funding and administration at all levels
PubMed
An international, freely searchable index to the medical literature. PubMed will help you to search for therapy, causation, diagnosis and prognosis articles, as well as systematic reviews
MEDLINE
A comprehensive source of life sciences and biomedical bibliographic information. It contains nearly 11 million records from more than 7,300 different publications dating from 1965-present. MEDLINE is updated weekly.
MEDLINEplus
An alternative to Medline for health consumers, a useful tool for health professionals as well
National Guideline Clearinghouse
Professional Associations
American College of Radiology
The principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States, with more than 30,000 members.
American Roentgen Ray Society
The oldest radiology society in the United States, providing monthly peer-reviewed journal and annual scientific assembly, as well as other radiology and educational resources.
Society of Interventional Radiologists
Minnesota Specialty Societies
AMA links to National Specialty Societies
Point-of-Care Clinical Decision Support
Clinical Decision Support Vendors
Amirsys STATdx™
Point-of-care diagnostic decision support in imaging designed to support the practicing radiologist.
iCONSULT
Solutions to meet clinical decision support needs
DynaMed
A clinical reference tool for physicians for use at 'point-of-care'. With clinically-organized summaries for nearly 2,000 topics, it is the only evidence-based reference that answers most clinical questions during practice. It is updated daily and monitors the content of over 500 medical journals and review databases directly and indirectly by using many journal review services.
FIRSTConsult
An evidence-based clinical information tool for health care providers. It synthesizes findings from journals and other evidence-based references in a structured format. It offers tools for differential diagnosis, evaluation and management of medical conditions, patient education, and procedure skills review. It is linkable from MDConsult, also.
Medicalis
Evidence-based decision support guidelines for diagnostic ordering, web-based applications at the point-of-care, and healthcare integration to link with other EHR applications.
RadPort™ Suite (Commissure)
Focuses on assisting referring clinicians with ordering radiology exams and accessing multi-media results for their patients. RadPort’s decision support criteria isbased on prior work by the American College of Radiology Appropriateness Criteria RadPort also has the ability to allow the referring physician to easily check the status of an exam and review the report after the exam has been performed.
UpToDate
A comprehensive evidence-based clinical information resource available to physicians by subscription. UpToDate is designed to get physicians the concise, practical answers they need when they need them the most - at point of care.
Physician Education and Quality Improvement Resources
Radiology Websites
BrighamRAD
An online learning resource for both the clinician and medical student from the Department of Radiology at Brigham and Women's Hospital.
PediatricRadiology.com
A pediatric radiology and pediatric imaging digital library
Radiology.org
A radiology directory and custom search services to radiologists and professionals in the medical imaging industry
RadiologyEducation.com
A digital library of radiology education resources
RadiologyInfo.org
Designed to answer patient questions related to the many radiologic procedures and therapies available
Quality Improvement Resources
AHRQ QualityTools
A clearinghouse for practical, ready-to-use tools for measuring and improving the quality of health care. QualityTools is sponsored by the Agency for Healthcare Research and Quality (AHRQ).
ICSI
ICSI champions health care quality and accelerates improvement in health care in Minnesota
MMA Quality Website
Tools and information for Minnesota physicians on quality improvement, measurement, HIT, and patient safety
National Quality Measures Clearinghouse
A clearinghouse for clinical metrics for measuring and improving the quality of health care. QualityTools is sponsored by the Agency for Healthcare Research and Quality (AHRQ).
Continuing Medical Education
CME in Minnesota
This calendar of CME activities is provided as a service of the Minnesota Medical Association Committee on Accreditation and CME.
Books
Google book search on Evidence-based imaging
Journal Articles
Blackmore, CC. (2005). “Clinical Prediction Rules in Trauma Imaging: Who, How, and Why?” Radiology 235:371–374.
Myriam Hunink, MG. “Decision Making in the Face of Uncertainty and Resource Constraints: Examples from Trauma Imaging” Radiology. 235:375–383.
Schellinger, PD; Fiebach, JB; Hacke, W; and Röther, J. (2003). “Imaging-Based Decision Making in Thrombolytic Therapy for Ischemic Stroke: Present Status.” Stroke 34;575-583.