ESR iGuide – Clinical Decision Support


Clinical decision support for European imaging referral guidelines


The European Society of Radiology considers referral guidelines for medical imaging essential for improving appropriateness and justification of radiological procedures. Particularly at a time of increasing financial pressure on European healthcare systems and public concerns about the risks of exposure to radiation, it is more important than ever to ensure medical imaging is used in the most efficient and most effective way possible.

To address to gaps in the availability of imaging referral guidelines and the lack of guideline use in Europe, the ESR is developing ESR iGuide, a clinical decision support system for European imaging referral guidelines, in cooperation with National Decision Support Company (NDSC). The aim is to provide a CDS platform at the point of care that provides evidence-based information and patient-tailored decision support tools relevant to imaging decisions. This is a vital step towards ensuring the appropriate use of radiation and avoiding unnecessary radiation exposure.

A team of senior radiologists appointed by the ESR started developing European imaging referral guidelines in November 2014, based on the Appropriateness Criteria developed by the American College of Radiology. This scientific review is overseen by a dedicated methodologist, and will provide a standard set of evidence-based guidelines for Europe. In cooperation with NDSC, the guidelines will be embedded into the ESR iGuide CDS platform for distribution in Europe. The ESR’s aim is to cover around 80 percent of requests in daily practice by reviewing the clinical scenarios, indications and recommendations for the topic groups Breast, Cardiac, Gastrointestinal, Musculoskeletal, Neurologic, Paediatric, Thoracic, Urologic, Vascular and Women’s Imaging.

A prototype of ESR iGuide was introduced during ECR 2015, with pilot projects being implemented since 2016. The stand-alone ESR iGuide web portal was launched at ECR 2018.