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U.S. Department of Health and Human Services

Radiation-Emitting Products

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Appropriate Use

It is estimated that as many as 30-50% of medical imaging exams are not medically necessary. FDA strongly promotes the efforts of other organizations in the area of appropriate justification of imaging exams through the development and adoption of appropriate-use criteria. An important aspect of reducing unnecessary exams is access to a patient's imaging history (see Education and Communication section). In addition, development and implementation of evidence-based appropriate use guidelines is crucial. Examples of efforts to promote appropriate use of imaging include:

  • The American College of Radiology publishes online, publicly accessible appropriateness criteria disclaimer icon ® to assist referring physicians and other medical professionals in making imaging decisions based on specific clinical conditions.
  • The American College of Cardiology developed appropriate-use criteria disclaimer icon for a variety of diagnostic imaging modalities and procedures used by cardiovascular professionals.
  • The CMS Medicare Imaging Demonstration (MID) was authorized by section 135(b) of the Medicare Improvements for Patients and Providers Act of 2008 with the goal of collecting data to determine the appropriateness of physician use of advanced diagnostic imaging services in relation to medical specialty guidelines. The 2-year Demonstration will assess the impact that decision support systems (DSSs) used by physician practices have on the appropriateness and utilization of advanced medical imaging services ordered for the Medicare fee-for-service (FFS) population.
  • FDA presented at the National Council on Radiation Protection and Measurements (NCRP) workshop (September 2009) on "CT in Emergency Medicine: Ensuring Appropriate Use." Summary recommendations were recently published.
  • The FDA presented at the International Atomic Energy Agency (IAEA) technical meeting on Justification of Medical Exposure in Diagnostic Imaging disclaimer icon .
  • The American Board of Radiology Foundation held a 2009 summit on "Medical Imaging: Addressing Overutilization in the Era of Healthcare Reform" disclaimer icon .
  • FDA is contributing to the development of new ICRP draft publications on justification in medical imaging.
     
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