0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Imaging More Wisely—Already At Work—Reply

Rebecca Smith-Bindman, MD1; Andrew B. Bindman, MD2
[+] Author Affiliations
1Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco
2Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco
JAMA Intern Med. 2016;176(6):870-871. doi:10.1001/jamainternmed.2016.2075.
Text Size: A A A
Published online

Extract

In Reply We are pleased that the American College of Radiology (ACR) “has worked for decades” to reduce unwarranted imaging and lower radiation dose, but given the substantial rise in unnecessary tests,1,2 and the dramatic variation in the radiation doses used in performing them even when patients are evaluated for the same clinical questions,3,4 it appears that the ACR’s strategy is not working. Perhaps the problem would be even worse without the efforts of the ACR, but the current situation cannot be considered acceptable. An independent assessment of the ACR’s appropriateness criteria determined that they had no effect on the use of imaging or the appropriateness of imaging when tested among more than 3900 imaging providers across 8 states.5 This finding is consistent with what has been found in many other aspects of clinical care. Voluntary guidelines are a weak lever to change physician practice behavior6 especially if the guidelines are not based on clear and convincing evidence7 or if they rely upon biased evidence or evidence perceived to be biased.8

Topics

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

June 1, 2016
Bibb Allen Jr, MD
1Grandview Medical Center, Birmingham, Alabama
JAMA Intern Med. 2016;176(6):870. doi:10.1001/jamainternmed.2016.2072.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

62 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();