ACR Success Tied to World-Class Research and Advocacy

The following post was contributed by Ruth Carlos, MD, FACR, co-chair of the Clinical Research Pathway of ACR 2016 — The Crossroads of Radiology®.

Carlos_RuthOver the years, radiologists have learned the importance of synergy between world-class research and political advocacy to gain acceptance for their life-saving contributions to medicine. Neither one alone assures success in the courts of clinical, political or public opinion.

The American College of Radiology (ACR) continues its commitment to imaging science.  It has relied on a solid base of clinical literature for the assessments that underlie its highly respected ACR Appropriateness Criteria®. Through the ACR Imaging Network (ACRIN), the College has sponsored influential imaging-related registries and clinical trials including the National Oncologic PET Registry (NOPR), National Lung Cancer Screening Trial (NLCS) and National CT Colonography Trial (NCCT).

This tradition continues with ACRIN’s current involvement the Imaging Dementia — Evidence for Amyloid Scanning (IDEAS) study, an experiment  that will involve more than 18,000 Medicare beneficiaries to determine if brain amyloid PET helps improve outcomes for Alzheimer’s disease patients.

But effective advocacy is also needed to affect public policies governing the acceptance of such new and expensive imaging technologies. As ACR members will learn at a session entitled “From Evidence to Reimbursementat ACR 2016 — The Crossroads of Radiology®, the definitive results of NLCS were just a starting point toward the ultimate decision by Centers for Medicare & Medicaid Services (CMS) to grant a National Coverage Determination for the low-dose CT screening procedure.  It came after careful and sometimes contentious maneuvering that led to threatened Congressional action.  (See more ACR 2016 clinical research sessions.)

The ACR faces a similar situation today with CMS resistance against granting Medicare reimbursement for CT colonography (CTC), a non-invasive screening procedure shown by NCCT to be diagnostically equivalent to invasive colonoscopy. Political advocacy has again proven to be essential, and it is taking the form of an ACR Call to Action that asks ACR members to contact their senators and representatives to co-sponsor the CTC Screening for Colorectal Cancer Act of 2016 (HR 4632/SB 2262).

Coverage decisions are multifactorial. They rely not just on the underlying science but also on soft skills, such as advocacy on part of the physicians and patients who wants to see good science translated into practice.

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