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Action 1: Justification


  • Introduce and apply the 3A’s (awareness, appropriateness and audit), which are seen as tools that are likely to facilitate and enhance justification in practice;
  • Develop harmonized evidence-based criteria to strengthen the appropriateness of clinical imaging, including diagnostic nuclear medicine and non-ionizing radiation procedures, and involve all stakeholders in this development;
  • Implement clinical imaging referral guidelines globally, keeping local and regional variations in mind, and ensure regular updating, sustainability and availability of these guidelines;
  • Strengthen the application of clinical audit in relation to justification, ensuring that justification becomes an effective, transparent and accountable part of normal radiological practice;
  • Introduce information technology solutions, such as decision support tools in clinical imaging, and ensure that these are available and freely accessible at the point-of-care;
  • Further develop criteria for justifi cation of health screening programmes for asymptomatic populations (e.g. mammography screening) and for medical imaging of asymptomatic individuals who are not participating in approved health screening programmes (e.g. use of CT for individual health surveillance).