MINNEAPOLIS, 2:19 p.m. CST, February 21 -- In a recent letter asking Minnesota health plans to withdraw their high-tech imaging requirements, the MMA recommended that health care providers rapidly move towards implementing decision tools like these evidence-based clinical practice guidelines.

Physicians seeking guidance on when high-tech imaging is appropriate may wish to use online resources provided by the American College of Radiology.

The American College of Radiology provides detailed new practice guidelines and technical standards for clinical practice.

ACR also offers an abbreviated set of trademarked Appropriateness Criteria for medical specialties: cardiovascular, gastrointestinal, oncology, etc. The urologic pages, for instance, contain an entry for “acute onset flank pain – suspicion of stone disease.” A CT scan for kidney is rated 8 of 10, or quite appropriate. An X-ray for the same condition is rated 1, for not appropriate.

But ARC underscores that guidelines are guidelines, not hard-and-fast rules. “The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician,” says ACR’s web site, “in light of all the circumstances presented.”

Likewise, the National Guidelines Clearinghouse is another useful public resource for evidence-based clinical practice guidelines. It includes decision guidelines by ARC and many other professional organizations.

The MMA will provide members with information about evidence-based guidelines on an ongoing basis.

The MMA also recommended a community-wide effort to collect information that will to improve its understanding of high-tech imaging use throughout Minnesota and the use of that data to address any inappropriate use of high-tech imaging.