SIRM #1

In occasion of the Executive Board meeting on 8 July 2013 the Italian Society of Medical Radiology – SIRM – has officially published 5 high-risk practices of inappropriateness identified by Slow Medicine under the project “Doing more does not mean doing better.”
A review of the literature was carried out based on common clinical practices that do not, in most cases, determine a clinical decision. The practices selected were chosen based on lack of efficacy, risk of damage from exposure to ionizing radiation, risk of over-diagnosis and over-treatment, and high diffusion in Italy; also inherently characterized by high costs. The identification of the procedures took into account the ACR appropriateness criteria https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Appropriateness-Criteria and the agreement between the Italian Minister of Health, the Italian Regions and Autonomous Provinces of Trento and Bolzano on the document entitled “Guidelines for diagnostic imaging” based on art. 4 of Legislative Decree of the 28th of August 1997, n.281.
Sources were reviewed in December 2022, and the document was further updated in January 2026, with approval by the SIRM Executive Board.
Although the “legge 101/ 2020” states that the justification of these practices is a responsibility of the MD Radiologist together with the prescriber, the case law and the daily practice make it difficult to consistently reject these requests in the absence of an appropriate awareness of prescribing doctors and general population.