SIRM #2

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.”
The Executive Board meeting on 24 June 2021 identified these additional 5 practices in the field of instrumental imaging on children and infants, given the particular peculiarity and significance of the need for appropriateness in pediatric x-ray exposure.
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 [http://www.acr.org/Quality-Safety/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.
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.