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. 2023 Mar 14;11(2):E248-E254.
doi: 10.9778/cmajo.20220098. Print 2023 Mar-Apr.

Canadian Association of Radiologists Diagnostic Imaging Referral Guidelines: a guideline development protocol

Candyce Hamel  1 , Ryan Margau  2 , Paul Pageau  2 , Marc Venturi  2 , Leila Esmaeilisaraji  2 , Barb Avard  2 , Sam Campbell  2 , Noel Corser  2 , Nicolas Dea  2 , Edmund Kwok  2 , Cathy MacLean  2 , Erin Sarrazin  2 , Charlotte J Yong-Hing  2 , Kaitlin Zaki-Metias  2
Affiliations

Canadian Association of Radiologists Diagnostic Imaging Referral Guidelines: a guideline development protocol

Candyce Hamel et al. CMAJ Open. .

Abstract

Background: Comprehensive diagnostic imaging referral guidelines are an important tool to assist referring clinicians and radiologists in determining the safest and best-clinical-value diagnostic imaging study for their patients; the Canadian Association of Radiologists (CAR) last produced its diagnostic imaging referral guidelines in 2012. In partnership with several national organizations, referring clinicians, radiologists, and patient and family advisors from across Canada, the association is redoing its referral guidelines using a new methodology for guideline development, and these guideline recommendations will be suited for integration into clinical decision support systems.

Methods: Expert panels of radiologists, referring clinicians and a patient advisor will work with epidemiologists at the CAR to create guidelines across 13 clinical sections. The expert panel for each section will first create a comprehensive list of clinical and diagnostic scenarios to include in the guidelines. Canadian Association of Radiologists epidemiologists will then conduct a systematic rapid scoping review to identify systematically produced guidelines from other guideline groups. The corresponding expert panel will develop diagnostic imaging recommendations for each clinical and diagnostic scenario using the recommendations identified from the scoping review and contextualize them to the Canadian health care systems. The expert panels will accomplish this using an adapted Grading of Recommendations Assessment, Development and Evaluation framework, which reflects the benefits and harms, values and preferences, equity, accessibility, resources and cost.

Interpretation: Freely available, up-to-date, comprehensive Canadian-specific diagnostic imaging referral guidelines are needed. A transparent and structured guideline-development approach will aid the CAR and its partners in producing guidelines across its 13 sections.

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Conflict of interest statement

Competing interests: Ryan Margau and Paul Pageau are co-chairs of the Canadian Association of Radiologists Diagnostic Imaging Referrals Guidelines Working Group. Erin Sarrazin is the membership director of the Nurse Practitioner Association of Canada. Charlotte Yong-Hing is the president of the BC Radiological Society and the president elect of the Canadian Society of Breast Imaging. Kaitlin Zaki-Metias is the trainee representative on the Canadian Society of Breast Imaging Board of Directors and serves on the RadioGraphics Trainee Editorial Advisory Members Board. No other competing interests were declared.

Figures

Figure 1:
Figure 1:
Project flow diagram. Note: CAR = Canadian Association of Radiologists, GRADE = Grading of Recommendations Assessment, Development and Evaluation.
Figure 2:
Figure 2:
Determining the strength of the recommendation. Created using the guidance provided in Andrews and colleagues.
See this image and copyright information in PMC

References

    1. Squires JE, Cho-Young D, Aloisio LD, et al. Inappropriate use of clinical practices in Canada: a systematic review. CMAJ. 2022;194:E279–96. - PMC - PubMed
    1. O’Sullivan JW, Albasri A, Nicholson BD, et al. Overtesting and undertesting in primary care: a systematic review and meta-analysis. BMJ Open. 2018;8:e018557. - PMC - PubMed
    1. Cao DJ, Hurrell C, Patlas MN. Current status of burnout in Canadian radiology. Can Assoc Radiol J. 2022 Aug 6;:8465371221117282. doi: 10.1177/08465371221117282. [Epub ahead of print] - DOI - PubMed
    1. European Society of Radiology (ESR) Methodology for ESR iGuide content. Insights Imaging. 2019;10:32. - PMC - PubMed
    1. RCR iRefer guidelines: making the best use of clinical radiology. London (UK): The Royal College of Radiologists; 2017.

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