Monitoring of clinical imaging guidelines part 3: norms, standards, and regulations.
It is known that the use of imaging in clinical situations is not always optimal, leading to suboptimal health care and potential radiation risk. There may be overuse of imaging, underuse, or use of the wrong modality. The use of clinical imaging guidelines is likely to improve the use of imaging, but roadblocks exist. Some of these relate to regulatory oversight and mandates. There is wide variation by country and region in the regulatory setting, ranging from actual absence of regulatory authorities to mandated availability of clinical imaging guidelines in the European Community. Collaborative efforts to ensure that clinical imaging guidelines are at least available is a good starting point. Regulatory oversight and support are necessary to ensure the use of clinical imaging guidelines. Regulations should address 3 areas: availability, clinical utilization, and adherence to and revision of guidelines. The use of both internal and external audits, with the aim of both use of and adherence to guidelines and quality improvement, is the best tool for enhancing use. The major challenges that need to be addressed, collaboratively, to ensure the dissemination and use of clinical imaging guidelines are the development of regulations, of regulatory structures that can be effectively deployed, and of benchmarks for adherence and for utility.
Nuclear Substances and Radiation Devices Licensing Division, Canadian Nuclear Safety Commission, Government of Canada.
Neil
N
Babcock
Medical Exposure Regulatory Infrastructure Team CRCE, Public Health England Chilton, Didcot, Oxfordshire, United Kingdom.
Steve
S
Ebdon-Jackson
Northwick Park Hospital, Harrow, United Kingdom.
Denis
D
Remedios
Radiation Protection of Patients Unit, International Atomic Energy Agency, Vienna International Center, Vienna, Austria.
Ola
O
Holmberg
Radiation Programme Department of Public Health, Environmental and Social Determinants of Health (PHE) Cluster of Family, Women's and Children's Health (FWC) World Health Organization (WHO), Geneva, Switzerland.
Maria
M
del Rosario Perez
Department of Radiology, Wake Forest University School of Medicine, North Carolina. Electronic address: mabettmann@gmail.com.
Michael A
MA
Bettmann
D054869:Clinical Audit / Q000331:legislation & jurisprudence / Q000592:standards; D003952:Diagnostic Imaging / Q000592:standards*; D005060:Europe; D033161:Government Regulation; D019983:Guideline Adherence / Q000331:legislation & jurisprudence / Q000592:standards; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence* / Q000592:standards*; D011871:Radiology / Q000331:legislation & jurisprudence* / Q000592:standards*; D014481:United States
Guideline monitoring; clinical imaging guidelines; imaging regulation; imaging standards