Variant 1: Acute respiratory illness in immunocompetent patients with negative physical examination, normal vital signs and no other risk factors. Initial imaging.
Variant 2: Acute respiratory illnesses in immunocompetent patients with positive physical examination, abnormal vital signs, organic brain disease or other risk factors. Initial imaging.
Variant 3: Acute respiratory illness in immunocompetent patients with positive physical examination, abnormal vital signs, organic brain disease, or other risk factors and negative or equivocal initial chest radiograph. Next Imaging Study.
Variant 4: Acute respiratory illnesses in immunocompetent patients with pneumonia complicated by suspected parapneumonic effusion or abscess on initial chest radiograph. Next Imaging study.
Variant 5: Acute asthma exacerbation in immunocompetent patients, uncomplicated (no suspicion of pneumonia or pneumothorax). Initial imaging.
Variant 6: Acute asthma exacerbation in immunocompetent patients, complicated (suspected pneumonia or pneumothorax). Initial imaging.
Variant 7: Acute COPD exacerbation in immunocompetent patients, uncomplicated (no chest pain, fever, or leukocytosis, no history of coronary artery disease, or heart failure). Initial imaging.
Variant 8: Acute COPD exacerbation in immunocompetent patients with accompanying chest pain, fever, or leukocytosis, or a history of coronary artery disease, or heart failure. Initial imaging.
Appendix Key

A more complete discussion of the items presented below can be found by accessing the supporting documents at the designated hyperlinks.

Appropriateness Category:The panel’s recommendation for a procedure based on the assessment of the risks and benefits of performing the procedure for the specified clinical scenario.

SOE: Strength of Evidence. The assessment of the amount and quality of evidence found in the peer reviewed medical literature for an appropriateness recommendation.

  • References: The citation number and PMID for the reference(s) associated with the recommendation.
  • Study Quality: The assessment of the quality of an individual reference based on the number of study quality elements described in the reference.

RRL: Relative Radiation Level. A population based assessment of the amount of radiation a typical patient may be exposed to during the specified procedure.

Rating: The final rating (1-9 scale) for the procedure as determined by the panel during rating rounds.

Median: The median rating (1-9 scale) for the procedure as determined by the panel during rating rounds.

Final tabulations: A histogram showing the number of panel members who rated the procedure as noted in the column heading (ie, 1, 2, 3, etc.).

Additional supporting documents about the AC methodology and processes can be found at www.acr.org/ac.