A MULTIPURPOSE MODEL OF RADIOLOGY APPROPRIATENESS CRITERIA

Rationale and Objectives. Appropriateness criteria and practice guidel ines are being developed in attempts to improve the cost-effectiveness of medical care. The authors sought to make a set of radiology approp riateness criteria usable for education, computer-based decision suppo rt, and utilization review. Model Development. Sixty clinical conditio ns from the American College of Radiology's appropriateness criteria w ere selected. To make the information more suitable for automation, th e names of the imaging procedures were standardized. Indexing terms we re assigned to identify clinical conditions and to distinguish between each condition's variants. Semantic relationships between terms were defined. Information about the clinical conditions and variants, radio logic procedures, indexing terms, and relationships was encoded into a standardized language for document interchange. Implementation. The 1 ,956 rows in the appropriateness criteria tables for the 60 clinical c onditions and their 212 variants were mapped into references to 163 di stinct imaging procedures. The system's knowledge base included 301 in dexing terms and 569 additional terms. Conclusion, Radiology appropria teness criteria can be indexed and encoded into a form that facilitate s their use and interchange. The use of open, internationally accepted standards is an important step to make such knowledge portable and su itable for integration with evolving computer-based patient record sys tems.