Optimizing Musculoskeletal Imaging Referrals: Making Wise Choices a Knee-Jerk Reaction.

IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Natalia Gorelik, Courtney R Green, Candyce Hamel, Anne-Marie LeBlanc, Bheeshma Ravi, Danielle R Frost, Hugue Ouellette, Kuan-Chin Jean Chen, Lisa Y Liang, Nitai Gelber, Reza Mirza, Kawan S Rakhra
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引用次数: 0

Abstract

Purpose: To develop Choosing Wisely Canada (CWC) recommendations for musculoskeletal (MSK) imaging indications, informed by the 2024 Canadian Association of Radiologists (CAR) Musculoskeletal System Diagnostic Imaging Referral Guideline. Methods: A Steering Committee comprising multidisciplinary MSK experts was convened to guide recommendation development. Using a two-round Delphi method, committee members selected the top 3 scenarios from the CAR MSK referral guidelines deemed most impactful for addressing overuse. Recommendations based on these scenarios were then drafted using the CWC format. Results: The 3 recommendations developed are: (1) Don't order MRI without first considering ultrasound for the assessment of rotator cuff pathology and bursitis; (2) Don't order MRI of the hip or knee when x-ray demonstrates greater than mild osteoarthritis, unless recommended by a musculoskeletal specialist; and (3) Don't order MRI of the hip just based on x-ray features of femoroacetabular impingement unless there are clinical signs and symptoms of joint impingement. Conclusions: This project represents a knowledge translation initiative to disseminate updated MSK imaging guideline recommendations. It strengthens the collaboration between CAR and CWC and establishes a reproducible structured consensus approach that can be applied to developing additional CWC imaging recommendations across the remaining 12 CAR referral guidelines in other subspecialties. This work supports value-based radiology, promoting optimized resource use.

优化肌肉骨骼成像转诊:做出明智的选择——下意识的反应。
目的:根据2024年加拿大放射医师协会(CAR)肌肉骨骼系统诊断成像转诊指南,制定明智选择加拿大(CWC)关于肌肉骨骼(MSK)成像适应症的建议。方法:召集了一个由多学科MSK专家组成的指导委员会来指导建议的制定。使用两轮德尔菲法,委员会成员从CAR - MSK推荐指南中选择了被认为对解决过度使用最有影响的前3个场景。然后使用《禁止化学武器公约》的格式起草了基于这些设想的建议。结果:提出的3条建议是:(1)在评估肩袖病理和滑囊炎之前,不要先考虑超声检查;(2)当x光片显示骨关节炎大于轻度时,除非肌肉骨骼专家建议,否则不要对髋关节或膝关节进行MRI检查;(3)除非有关节撞击的临床体征和症状,否则不要仅仅根据股髋臼撞击的x线特征就进行髋关节MRI检查。结论:该项目代表了一项知识翻译倡议,旨在传播最新的MSK成像指南建议。它加强了CAR和CWC之间的合作,并建立了可重复的结构化共识方法,可用于在其他亚专科的其余12个CAR转诊指南中制定额外的CWC成像建议。这项工作支持基于价值的放射学,促进资源的优化利用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.20
自引率
12.90%
发文量
98
审稿时长
6-12 weeks
期刊介绍: The Canadian Association of Radiologists Journal is a peer-reviewed, Medline-indexed publication that presents a broad scientific review of radiology in Canada. The Journal covers such topics as abdominal imaging, cardiovascular radiology, computed tomography, continuing professional development, education and training, gastrointestinal radiology, health policy and practice, magnetic resonance imaging, musculoskeletal radiology, neuroradiology, nuclear medicine, pediatric radiology, radiology history, radiology practice guidelines and advisories, thoracic and cardiac imaging, trauma and emergency room imaging, ultrasonography, and vascular and interventional radiology. Article types considered for publication include original research articles, critically appraised topics, review articles, guest editorials, pictorial essays, technical notes, and letter to the Editor.
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