iMedical Apps: A Better Take on Appropriateness Criteria for Imaging

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? As front-line primary care providers, we need to order the correct test when we see our patients to avoid callbacks, cancelled appointments, and frustrated patients and radiologists. The American College of Radiology (ACR) has published numerous guidelines on proper imaging and has a dedicated website to their appropriateness criteria.

The ACR has recently released an app that provides guidance on several, but far from all, of the areas available on their website or in the Rads Consult app. The app, called ACR Guidance, provides important content on the management of contrast reactions, the recently released Thyroid Imaging Reporting & Data System (TI-RADS), and information on how to approach incidental findings of adrenal masses. Unfortunately, only those three topics are currently included in the app.

When I was assisting a resident in the clinic this week on determining the proper test to order for a patient, I again consulted the non-mobile-friendly ACR website to find the answer and remained frustrated that a dedicated app was non-existent. I stumbled upon an app called ACR: Appropriateness Criteria in the Apple App Store. Designed by a medical student, the app has no official relationship to the ACR, but provides a mobile-friendly web app of the entire ACR Criteria including the 2020 updates!


  • Provides ACR criteria in an app
  • Contains links to the actual ACR documents via PDFs
  • Includes Evidence Table, Lit Search, Narrative, and Rating Table for each AC


  • Very basic interface with no additional information about app creator or use
  • Some links do not work; requires internet access for content
  • Not available for Android

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Last Updated July 17, 2020