Document Detail


Evidence-based radiology: why and how?
MedLine Citation:
PMID:  20069736     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To provide an overview of evidence-based medicine (EBM) in relation to radiology and to define a policy for adoption of this principle in the European radiological community. RESULTS: Starting from Sackett's definition of EBM we illustrate the top-down and bottom-up approaches to EBM as well as EBM's limitations. Delayed diffusion and peculiar features of evidence-based radiology (EBR) are defined with emphasis on the need to shift from the demonstration of the increasing ability to see more and better, to the demonstration of a significant change in treatment planning or, at best, of a significant gain in patient outcome. The "as low as reasonably achievable" (ALARA) principle is thought as a dimension of EBR while EBR is proposed as part of the core curriculum of radiology residency. Moreover, we describe the process of health technology assessment in radiology with reference to the six-level scale of hierarchy of studies on diagnostic tests, the main sources of bias in studies on diagnostic performance, and levels of evidence and degrees of recommendations according to the Centre for Evidence-Based Medicine (Oxford, UK) as well as the approach proposed by the GRADE working group. Problems and opportunities offered by evidence-based guidelines in radiology are considered. Finally, we suggest nine points to be actioned by the ESR in order to promote EBR. CONCLUSION: Radiology will benefit greatly from the improvement in practice that will result from adopting this more rigorous approach to all aspects of our work.
Authors:
Francesco Sardanelli; Myriam G Hunink; Fiona J Gilbert; Giovanni Di Leo; Gabriel P Krestin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European radiology     Volume:  20     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-12     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1-15     Citation Subset:  IM    
Affiliation:
Dipartimento di Scienze Medico-Chirurgiche, Unit? di Radiologia, IRCCS Policlinico San Donato, Universit? degli Studi di Milano, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy. f.sardanelli@grupposandonato.it
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MeSH Terms
Descriptor/Qualifier:
Clinical Trials as Topic / trends*
Diagnostic Imaging / trends*
Evidence-Based Practice / trends*
Internationality
Radiology / trends*

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