Finally a Native App to Access the American College of Radiology (ACR) Guidelines, But at a Price!

One of the steepest learning curves in residency education is deciding what imaging tests to order for patients. Should I order an X-ray first or go straight to computed tomography (CT) or magnetic resonance imaging (MRI)? Do I order contrast? How do I handle an incidental finding when I get back the CT report? What is the imaging study of choice for a patient with hematuria? Not only are these questions daunting for students and residents, but they can also remain challenging even for seasoned providers. Some believe ordering is easy and it is the interpretation that is the hard part. 

To a certain degree, this is true, but most of us are not reading our own CT, MRI, and ultrasounds — or even X-rays — we rely on our radiologists for the interpretation. For providers with a good relationship with their radiology department, they can perhaps just pick up the phone and ask what the best test to order for a given situation. But this is not practical most of the time for primary care providers or radiologists in a busy patient care environment. Ordering the incorrect test can lead to improper/missed diagnoses, incidental findings, unnecessary radiation exposure, delays in testing, and other harms.

The American College of Radiology (ACR) has published numerous guidelines on proper imaging and has a dedicated website to their Appropriateness Criteria (AC). These criteria are available free of charge to non-members but can be daunting to navigate via mobile device. No true dedicated ACR app exists for the AC from the ACR. Previously, we had favorably reviewed the web app Rads Consult and it has become my go-to rads app while in clinic or on the wards. The authors of Rads Consult have returned with a native app for iOS and Android. It is as amazing as the web app — fast, flawless, with much-needed information. Unfortunately, the native app is not free like the web app (which is no longer being maintained) and requires a $14.99 annual subscription as well. It does come with a free two-week trial so definitely worth checking out.   

Evidence-based medicine

The new Rads Consult native app contains the ACR recommendations for virtually every diagnosis/radiographic imaging scenario. The app includes access to the actual ACR PDFs (or equivalent, ie-nuclear medicine society) from within the app. Key sections are written by radiologists specialized in that area/modality. Users can access the ACR recs via symptom/diagnosis, imaging modality, or body system modalities. Finally, the app contains additional ACR and expert opinion on common radiology questions/answers, incidental findings, and more. Although the ACR recs are largely expert opinion-based, they remain the standard of care. The use of this app will help to ensure patients receive the proper imaging studies and avoid unnecessary imaging, unnecessary radiation exposure, and potentially prevent secondary sequelae from imaging studies, radiation, contrast, etc.

What providers would benefit from this app?

Students, residents, mid-levels, primary care providers, hospitalists, emergency medicine, radiologists, nurses, any staff provider who orders radiographic studies.

Price

o Free.

Likes

  • Interface is easy to use with multiple options to access ACR recommendations
  • Contains links to the actual ACR documents via PDFs and an extensive Q/A section.
  • Available for iOS and Android as native apps

 

Dislikes

  • Expensive as an annual subscription
  • Need active internet connection to download PDFs
  • No section just listing ACR criteria/documents

Overall

The new native app version of Rads Consult replaces the outstanding web app version that I have been using for many years. Rads Consult brings the most current ACR recommendations for selecting radiographic studies to your iOS/Android devices without having to be a radiologist or ACR member. The web app still “works”, but is no longer being maintained. Every provider can ensure they are ordering the proper radiologic studies for a specific patient’s condition/suspected condition using this native app. This remains a must-have app for providers, but the annual subscription cost will be a barrier for some.

Overall Score

o 4.0 stars

User Interface

o 5.0 stars

Fast and easy to use interface with multiple modalities to access ACR recs per user preference including by system, by body part, and by exam type. 

Multimedia Usage

o 4.5 stars

New native app allows for users to access ACR recs via diagnosis, body system, or imaging modality. The interface contains access to the actual ACR PDFs and numerous other tables and charts easily viewable on most smart devices/computers. You can even submit your own questions in the Q/A section!

Price

o 3.0 stars

$14.99/annually. It is not that the app isn’t worth this amount, but to see it go from completely free to now an annual subscription is a bit of a shock. Why doesn’t the ACR put out a real app of their guidelines for free?

Real-World Applicability

o 5.0 stars

A must-have app for any provider of any background who orders and interprets radiology studies. Rads Consult provides users access to the most current ACR recommendations in an easy to use interface for both iOS and Android devices. Unfortunately, it now comes at a price which may be too steep for some.

Device Used For Review

o iPhone 8 running iOS 14.2.     

Available for iOS devices including iPhone and iPad. Also available for Android devices.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.