Developing Algorithm-Based Recommendations in the ACR: Defining a New Process.
Nov 10, 2025DOI: 10.1016/j.jacr.2025.09.018Journal ArticleJACR
Written by: Stella K KangJenny HoangTarik AlkasabJacqueline A BelloLincoln BerlandJay BronnerMythreyi ChatfieldDavid KurthEtta PisanoJames V RawsonDavid SeidenwurmJeffrey WeinrebHanna M ZafarPari V Pandharipande
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LB
Dr. Lincoln Berland
Abdominal Imaging · UAB
JR
Dr. James Rawson
Abdominal Imaging · BIDMC
Summary
We summarize a new process for developing algorithm-based recommendations for the ACR. This process is currently applied to the ACR's incidental findings recommendations, and other committees providing evidence-based recommendations may elect to adopt these processes in the future. The prior process relied upon informal consensus and was versatile but more limited in scalability and generalizability. Most importantly, the absence of a formal, evidence-driven process prevented incidental findings and other algorithms from receiving designation as clinical guidelines per the National Academy of Medicine's Trustworthy Guidelines criteria and limited both referrer and policymaker adoption. In response, a committee of key stakeholders was formed with approval of the ACR to develop a new process that would overcome these drawbacks, including members from the ACR's Incidental Findings and Reporting and Data Systems committees, the ACR's Commissions on Quality and Safety and Informatics, academic and private practice settings, as well as ACR staff. Here we present the formal, evidence-driven process for algorithm-based imaging recommendations developed by this committee. This process is generalizable to committees across the ACR.
JR
Dr. James Rawson
Radiology · Abdominal ImagingBeth Israel Deaconess Medical Centerjamesrawson
