The Value of Research
We need data to determine appropriate use for reimbursement purposes and to inform health policy decisions.
The ACR’s core purpose is to serve patients and society by empowering members to advance the practice, science, and professions of radiological care. Research and innovation is the foundation on which our radiology clinical practice is built.
Without the research of Godfrey N. Hounsfield, there would be no CT. Without the research of Michel M. Ter-Pogossian, there would be no clinical PET. Without the research of Paul C. Lauterbur, there would be no MRI. Moreover, beyond technical development, research provides us with an understanding of the appropriate use and indications for tests developed — allowing for the best possible outcomes for our patients. In demonstrating and monitoring of patient benefit, research provides the evidence of our value for reimbursement.
There are two organizational research arms under the ACR Commission on Research — the Center for Research and Innovation™ (CRI), led by Charles K. Apgar, MBA, and the Harvey Neiman Health Policy Institute®, led by Danny R. Hughes, PhD. Both these organizations are overseen by Etta D. Pisano, MD, FACR, chief research officer of the ACR.
The purpose of the CRI is to drive science to practice and policy — facilitating future practice innovations through research and education for the benefit of patient outcomes, patient experience, and population health. The CRI operates solely through grant and commercial funding and does not receive funds otherwise from the ACR.
Clinical trials in which the CRI/ACR Imaging Network (ACRIN) has provided leadership include the following:
- The National Lung Screening Trial (NLST), which paved the way for lung screening for cancer in patients with a 30-pack per year or greater smoking history
- The Digital Mammography Imaging Screening Trial (DMIST), which showed that digital mammography is more accurate in women under the age of 50 years, women with radiographically dense breasts, and premenopausal or perimenopausal women
- The National Oncologic PET Registry, which was developed to help CMS determine the indications for PET scan coverage
In 2012, ACRIN merged with the Eastern Cooperative Oncology Group (ECOG) in cancer therapy forming the ECOG-ACRIN. The ACRIN component of this collaborative group is led by Mitchell D. Schnall, MD, PhD, FACR, chair of the department of radiology at the University of Pennsylvania’s Perelman School of Medicine. Under the auspices of ECOG-ACRIN, the Tomosynthesis Mammography Screening Trial (TMIST) — which will determine whether 3D mammography will improve breast cancer detection in asymptomatic women — has been funded and is ongoing. Under the CRI are multiple volunteer-driven research committees, including committees on neuroimaging, cardiovascular imaging, and pediatric research. Radiation oncology is a strong collaborative partner through the Imaging and Radiation Oncology Core and the NRG Cooperative.
The Neiman Institute, established in 2012, studies the role and value of radiology in evolving healthcare delivery and payment systems — including quality-based approaches to care and the impact of medical imaging on overall healthcare costs. Multiple articles are published each year, providing valuable information to our lawmakers, regulators, and payers to make informed decisions that involve imaging.
Without these research efforts, the data needed to determine appropriate use for reimbursement purposes and to make health policy decisions would not always be available to the extent necessary and with the timeliness needed. The data generated by the CRI is often funded by the National Institutes of Health, and the articles published based on data from CRI-driven trials and Neiman Institute research are published in peer-reviewed journals. Both the NLST and DMIST trials were published in the New England Journal of Medicine. Hence, the data generated through these valuable ACR functions provide objective evidence to support the best uses of imaging — increasing the value of radiology and allowing us, as radiologists, to provide the best care for our patients.
Learn more about the organizational structure of the ACR Commission on Research and view the full list of its volunteer committees.
Guest Columnist Pamela K. Woodard, MD, FACR, Chair of the ACR Commission on Research