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International Radiology Quality Network

IRQN    Collaboration is strength


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3rd Virtual Congress from the International Society of Radiology

Following the successful Congresses held in 2007 and 2009, the International Society of Radiology will launch the 3rd Virtual Congress in April 2011. This Congress will adopt a similar format used in the previous Congresses.

The presentations will fall into three categories:

  • Presentations featuring a different country each week, comprising Brazil, France, Korea and Russia. Speakers from each country will present: 2 Multimedia Refresh Courses; 2 Radiological Interactive Cases; an overview and a historic account of the country; and a virtual tour including photos and highlights.

  • Invited lectures by an expert panel of international speakers, assembled by the International Commission on Radiologic Education of the ISR. Two to three speakers will provide PowerPoint format (including audio) lectures each day.

  • Radiological Cases and Electronic Posters provided by the radiology community worldwide.

To find out more and register
Participation is FREE!

Radiation Protection Symposium during the 5th Congress of the Asian Society of cardiovascular Imaging

The 5th Congress of the Asian Society of Cardiovascular Imaging (ASCI 2011) is jointly organized by the Hong Kong College of Radiologists and the Hong Kong College of Cardiology. The Congress will be held at the Hong Kong Convention and Exhibition Centre, Hong Kong SAR, China, from 17th to 19th June, 2011.

Members of the ASCI are cardiac imagers from countries in Asia and beyond. The delegates will include radiologists, cardiologists, imaging technologists, nurses, health care managers, and medical physicists.

On behalf of the Organizing Committee, the Congress Presidents, Dr. Lilian Leong and Dr. Chung-Seung Chiang, invited the International Radiology Quality Network (IRQN) to collaborate with the Hong Kong College of Radiologists (HKCR) and the Hong Kong Association of Medical Physics (HKAMP) and to jointly organize a Radiation Protection Symposium in conjunction with the Congress on 17th June 2011. This Symposium will focus on radiation safety, radiation risk and dose reduction.

Radiation safety and protection to patients and staff are important issues, particularly when dealing with procedures using higher exposures, e.g. interventional cardiac procedures, cardiac CT, PET/SPECT imaging etc. The Symposium’s objective is to promote awareness, share knowledge and advocate good medical practice and radiation safety in clinical settings through an appropriate and optimal use of medical radiation. This action is very timely and would be of great interest to the delegates in view of an increasing public awareness on the benefits and risks of radiation used in medicine.

The Network thanks the Organizing Committee for their kind invitation and looks forward to contributing to the Symposium.

Congress details are available from: http://www.asci2011.org

Stakeholders to collaborate on referral guidelines

Diagnostic imaging and interventional radiology are indispensible in health care and save lives.  There is an increasing use of these procedures in recent years, some of which are associated with an increase in radiation exposure.  The stakeholders support professionalism, are committed to best patient care and are working towards better quality, safer and more appropriate use of these procedures.  For example, in radiation safety and radiation protection, there is an increase in interest and actions in recent years from international agencies, professional organizations and competent authorities to promote appropriate use and to reduce unnecessary exposure.
 
Under its Global Initiative on Radiation Safety in Health Care Settings (Global Initiative), the WHO hosted a consultancy on “Referral Guidelines for Appropriate Use of Radiation Imaging” in Geneva during March 2010.  The objectives were to consult the stakeholders and conceptualize the ways forward to: 1) develop an international set of evidence-based referral guidelines; 2) facilitate their implementation; and 3) monitor their use and evaluate the impact in different clinical settings.
 
WHO launched the Global Initiative in December 2008.  Reduction of unnecessary medical exposure by justification of radiological procedures is one of the initial priorities.  “An area of concern is the unnecessary use of radiation when clinical evaluation or other procedures could provide an accurate diagnosis.  Justification and optimization are the key pillars of radiation protection of patients.  During the coming year, the team’s work will focus on justification and related aspects, including referral guidelines.” explained Dr. Maria Neira, Director Department of Public Health and Environment, WHO.
 
Dr. Carlos Dora on behalf of Dr. Neira, together with Dr. Steffen Groth, Director Department of Essential Health Technologies of the WHO jointly opened the consultancy and welcomed the 35 participants from 19 countries.  The invited participants were experts from 23 international, regional and national agencies and professional organizations representing the: American College of Radiology (ACR), Argentine Society of Radiology (SAR), African Society of Radiology (ASR), Association of General Practitioners (Geneva), Canadian Association of Radiologists (CAR), Chinese Society of Radiology (CSR), European Commission (EC), European Society of Radiology (ESR), Federal Office for Radiation Protection, Germany (BfS), Hong Kong College of Radiologists (HKCR), Inter-American College of Radiology (CIR), Image Gently Campaign, International Atomic Energy Agency (IAEA), International Paediatric Association (IPA), International Radiology Quality Network (IRQN), International Society of Radiology (ISR), International Society of Radiographers and Radiological Technologists (ISRRT), National Centre for Child Health and Development, Japan (NCCHD), Nuclear Safety Authority, France (ASN), Pan American Health Organization (PAHO), Royal and Australian New Zealand College of Radiologists (RANZCR),  Royal College of Radiologists (RCR) and World Health Organization (WHO). The International Commission on Radiological Protection (ICRP), World Federation of Nuclear Medicine and Biology (WFNMB) and the World Federation of Ultrasound in Medicine and Biology (WFUMB) were invited and supportive but were unable to attend.
 
During the three days of the consultancy, the delegates shared their experience and views in a comprehensive program covering: why referral guidelines are needed; how to developing referral guidelines; the existing referral guidelines including their strengths and weaknesses; the ways forward to develop and present the material; the project framework and work plan; the implementation barriers and solutions; and the next steps.
 
There were active contributions from the participants during the discussions.  Following the exchange of views and opinion, there was consensus and an overwhelming support to the project from this group of experts.  However, it was recognized that there were areas which would benefit from further attention during project development.  For examples, there is a need to: better define the targeted audience; emphasize the educational value; note the different terminologies used in different countries; address the conflict of interest; attend to the costs if developing de novo; note the need for regular updates and medico-legal implications.  These important observations were noted and strategies will be developed to tackle these challenges.
 
At the end of the consultancy, the delegates agreed to collaborate and work towards the common objective and develop a common set of referral guidelines on an appropriate use of diagnostic imaging and interventional procedures.  The delegates agreed that it was feasible to conduct an international project to achieve this goal.  Based on the tabled framework some fine-tuning is needed in the roles of the stakeholders, the collaboration framework and the work plan towards the development, publication, distribution, implementation and evaluation of referral guidelines.
 
The participants have agreed to: 1) ensure on-going communication, consultation and collaboration; 2) include the development, pilot, implementation and evaluation of referral guidelines in the project scope; 3) define the roles of stakeholders;  4) apply an inclusive multi-stakeholder engagement framework and accountable work plan; 5) establish a core group to spearhead the project; 6) finalize and publicize the consultancy report; 7) promote awareness and develop key messages; 8) strengthen advocacy, member states policies and implementation strategies for justification and use of referral guidelines; and 9) develop specific implementation strategies for different settings.
 
The development and implementation of referral guidelines and appropriateness criteria is one of International Radiology Quality Network’s terms of reference.  The network formed a referral guidelines working group in June 2009 which is co-convened by Dr. Martin Reed from the Canadian Association of Radiology and Dr. Michael Kawooya from the African Society of Radiology.  “The IRQN looks forward to collaborating with other stakeholders to develop and implement evidence-based guidelines under an inclusive and collaborative framework” said Dr. Lawrence Lau, Chairman of IRQN.
 
There is a need to strengthen stakeholder engagement to promote awareness, to encourage participation towards the preparation and use of these guidelines; to develop implementation strategies; to build national capacity; and to apply effective implementation policies.  Referrers, imaging specialists, interventionists and radiographers are the key end-users of these guidelines, could actively participate by promoting awareness and applying these evidence-based tools to improve practice or by contributing to the development and implementation efforts as collaborators.  Collaboration is strength and provides synergy.  Those individuals who are interested to contribute to the referral guidelines working group can contact the IRQN secretariat at secretariat@irqn.org.  These collective efforts from the stakeholders will result in better quality, safer and more appropriate use of diagnostic imaging and interventional radiology.

IRQN welcomes the Chinese Society of Radiology

The Chinese Society of Radiology (CSR) is a non-profit national organization, devoted to the research and clinical practice of radiological sciences.  The society was founded in Shanghai in 1937 and is affiliated to the Chinese Medical Association.  The mission of the CSR is to foster interdisciplinary collaboration among physicians and scientists in the broad area of radiology and promote the development of radiology in China.  

The last two decades have seen rapid development of radiology in China.  The CSR hosts an annual national conference and a new Board is elected every four years.  Professor Jian-Ping Dai was the President of the 9th and 10th Boards and Professor Ji Qi was the President of the 11th Board. Under the new regulations of the Chinese Medical Association, a new Board is now elected every three years instead of four.  Professor Qiyong Guo is the current President of the Chinese Society of Radiology.  

“Thank you very much for your introduction to IRQN.  I am very happy you have invited CSR to join your organization.  On behalf of the Chinese Radiology of Society, I would like to announce that CSR can join IRQN and work together with other team members on the radiology service quality control and improvement...” said Professor Guo.  

There are at least 60,000 radiologists currently working in China. The CSR has established a number of subcommittees focusing in the subspecialties, including: abdominal radiology, musculoskeletal radiology, neuroradiology, cardiothoracic radiology, pediatric radiology, interventional radiology, magnetic resonance imaging, breast imaging and radiological technologies. The radiological technologies subcommittee has became an independent committee directly under the Chinese Medical Association.  A study group on molecular imaging was also established.  To encourage and promote young Chinese radiologists to participate in the development of radiology in China, a new committee named “The Youth Committee of Chinese Society of Radiology” was recently formed.  

The CSR will participate, together with other IRQN members, in the recently announced IRQN referral guidelines project by nominating members to the working group.

IRQN Referral Guidelines Working Group

The International Radiology Quality Network (IRQN) is pleased to announce the formation of a Referral Guidelines Working Group to develop a set of referral guidelines applicable to the health care settings in developing nations.  At the present time, nine of its member organizations have nominated representatives to this initiative.  

New techniques and new technologies have revolutionized diagnostic imaging in the last thirty years.  It could be challenging for most referrers to keep abreast of these new developments and select an appropriate diagnostic imaging examination for a given clinical problem.  In good medical practice, requesting a diagnostic imaging examination does not replace a careful and detailed clinical history and examination.  In fact, in many situations, patient management does not require further investigation be it diagnostic imaging or pathology.  Diagnostic imaging is only indicated when the management depends on the imaging findings.  In that scenario, further consideration should be given to the benefits versus the risks and side-effects of the examination.  

Well-developed and evidence-based referral guidelines are useful tools to assist referrers to decide if imaging is indicated.  The most appropriate examination to be selected is based on the information required, i.e. changes in structure or function; local resources; expertise; cost-effectiveness; and side effects including radiation exposure.  The diagnostic imaging needs of special patient groups, e.g. the use of radiation in imaging for children must be carefully evaluated.  

Justification and optimization are key measures to encourage an appropriate use of diagnostic imaging and to reduce unnecessary and unintended radiation exposure in health care settings.  The objective of this IRQN initiative is to provide guidance to the referrers by the publication of referral guidelines, i.e. justification of examination.  The working group intends to modify and harmonize the available referral guidelines and to adapt these to the health care setting of developing nations. “The challenge for all stakeholders is to select and perform the right examination, in a timely manner, with the right exposure which is appropriate for the local setting” said Lawrence Lau, Chairman of the IRQN.  

The IRQN Referral Guidelines Working Group will be led by the Co-Covenors Michael Kawooya and Martin Reed.  The Working Group members are: Ibtissem Bellagha, Azza Hammou and Michael Kawooya from the African Society of Radiology (ASR); Michael Bettman and Pamela A. Wilcox from the American College of Radiology (ACR); Byung Ihn Choi from the Asian Oceanian Society of Radiology (AOSR); Martin Reed and David B. Vickar from the Canadian Association of Radiologists (CAR); Lilian L. Y. Leong from the Hong Kong College of Radiologists (HKCR); Alfredo Buzzi and Rodrigo Restrepo González from the Inter-American College of Radiology (CIR); Cynthia Cowling, Paivi Wood and Sandy Yule from the International Society of Radiographers and Radiological Technologists (ISRRT); Richard Baron, Ramin Khorasani and Mark Watson from the Radiological Society of North America (RSNA), and Richard Mendelson and Don Swinbourne from the Royal Australian and New Zealand College of Radiologists (RANZCR); and Lawrence Lau from the International Radiology Quality Network (IRQN).  The European Society of Radiology (ESR) has nominated Jane Adam and the Royal College of Radiologists (RCR) has nominated Rob Manns as observers.  

Michael Kawooya is the General Secretary of the African Society of Radiology.  “This IRQN referral guidelines initiative is a timely proposal.  In Africa, radiologists, radiographers and other users of radiation for diagnostic purposes eagerly await these international guidelines for radiological referrals.  This is especially important and urgently needed in Africa where resources are limited.  Indeed, my country has just finalized the national standards and guidelines for radiology and imaging which will be binding for all radiology and imaging users in Uganda, and I was part of the team.  This national policy would be greatly enhanced by global efforts to harmonize and regularize radiology and imaging referrals” said Dr. Kawooya.  

Martin Reed is a pediatric radiologist with special interests in ultrasound and MSK imaging.  He is very interested in health services research, which has led him into referral guidelines.  Martin has been very interested in radiology guidelines for several years.  He is the Chair of the Guidelines Working Group for the CAR and is leading the revision of their set of guidelines.  As a member of Guidelines International Network (G.I.N.), he has had the opportunity to attend several international meetings on guidelines.  “There are already several versions of guidelines for developed countries and representatives from some of the groups are on this Working Group.  The CAR believes it would be appropriate to have a different set of guidelines for at least some of the developing nations because of their limited resources and their different disease burdens” said Dr. Reed.  

Given the scope of this initiative, it is expected that some lead time is required for the Working Group to develop the work plan, allocate tasks and draft guidelines.  “Collaboration is strength” is the network’s motto.  Despite these challenging tasks ahead, the network is confident that the Working Group will be well supported by the member organizations and the initiative will advance steadily in the coming years, leading to the publication of a first set of internationally developed referral guidelines which is appropriate for the developing nations.

More here

GO RAD: New ISR Educational Global Outreach Initiative

GO RAD is a new global outreach program developed by the International Society of Radiology (ISR). The purpose is to reach out to and advance radiology education throughout the radiology community worldwide with contents targeted and dedicated to developing nations and underserved populations.

Under the GO RAD Initiative, there is free access to a new collection of selected, current and practical radiology articles every month, courtesy of the ISR and some of the world's most prestigious radiology journals.

Eric J. Stern, of the University of Washington and Special Consulting International Editor for the AJR, serves as the editor-in-chief for GO RAD.  Twelve editorial board members, appointed from participating journals, will be responsible for setting editorial policy, developing selection criteria for applicable content, and subsequent identification of articles.  The aim is to select fundamental or review-type articles with educational content that transcend international boundaries on topics that address public health issues and are helpful to radiologists and related health care providers in all parts of the world.

The ISR website provides free access to GO RAD, the ISR Virtual Congress lectures, cases and posters and an online textbook, “The Imaging of Tropical Diseases” by Philip E.S. Palmer and Maurice M. Reeder.

Please share this announcement with your colleagues!

WHO Global Initiative on Radiation Safety in Healthcare Settings

The Global Initiative on Radiation Safety in Healthcare Settings (GIRSHS) is conducted by the Department of Public Health and Environment (PHE) and its Interventions for Healthy Environmental Unit under the Health Security and Environment Cluster (HSE). The aim is to promote safer use of radiation and protect patients, workers and the community in healthcare settings. The IRQN was invited to participate in a Technical Meeting which was held on 15th to 17th December 2008 following a preliminary meeting in June.

The meeting was attended by invitees from developed and developing Member States, organizations (ACR, ALATRO, ASN, ASTRO, EC, ESTRO, FORO, IAEA, ICRP, ILO, IOMP, IRPA, IRQN, ISR, ISRRT, RCR and UNSCEAR) and WHO personnel.

The GIRSHS will identify and engage a broad range of stakeholders as partners and end-users. A discipline and systematic approach will be adopted to handle the key risks in radiation medicine, employing risk assessment, risk control, risk management and risk communication elements. Clearly articulated aims, principles and prioritized activities will shape the initiative’s framework. A well-constructed work plan will be required for an initiative involving many stakeholder groups from the disciplines of diagnostic imaging, interventional radiology, radiotherapy and nuclear medicine.

Collaboration is strength” is the network’s motto and coordination will enable a more effective use of resources. The IRQN looks forward to actively participating in this exciting initiative.

More information about the GIRSHS is available from here
 

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A team of IRQN Referral Guidelines Working Group members were invited to a WHO consultancy on “Referral Guidelines for Appropriate Use of Radiation Imaging” in its Geneva HQ during March 2010.  The 35 invited experts from 19 countries representing 23 international, regional and national agencies and professional organizations have agreed to collaborate and work towards the common objective and develop a common set of referral guidelines on an appropriate use of diagnostic imaging and interventional procedures.  The experts also agreed that it was feasible to conduct an international project to achieve this goal…   More here
 

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