The development of radiology guidelines in Canada, Part 1

Area of Science:

• Radiology
• Health Services Research
• Clinical Practice Guidelines

Background:

• National and provincial initiatives in Canada aim to establish clinical practice guidelines for radiological services.
• The Canadian Association of Radiologists (CAR) has been involved in developing appropriateness guidelines for diagnostic imaging since 1994.
• Previous guidelines from the UK and US were reviewed to inform the Canadian approach.

Purpose of the Study:

• To outline the history and process of developing Canadian clinical practice guidelines for radiological services.
• To establish a framework for creating condition-based appropriateness guidelines in diagnostic imaging.
• To foster interdisciplinary consensus in guideline development tailored to Canadian practice.

Main Methods:

• Review of existing British and US radiology guidelines.
• Development of guidelines based on the Browman and associates' Guidelines Development Cycle.
• An interdisciplinary consensus approach tailored to Canadian practice.

Main Results:

• Guidelines are condition-based, not all-encompassing or equipment-based.
• Guidelines are being developed in collaboration with the Health Services Research in Radiology Initiative at McMaster University.
• Guidelines are in progress or completed for various applications, including chest radiography, foot and ankle injuries, deep-vein thrombosis diagnosis, and ultrasonography in normal pregnancies.

Conclusions:

• The CAR is actively involved in developing tailored, condition-based appropriateness guidelines for diagnostic imaging in Canada.
• The process emphasizes interdisciplinary consensus and avoids sole "ownership" of guidelines.
• This initiative aims to improve the quality and appropriateness of radiological services across Canada.