Canadian Association of Radiologists Diagnostic Imaging Referral Guidelines: a guideline development protocol

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Figure 1:
Project flow diagram. Note: CAR = Canadian Association of Radiologists, GRADE = Grading of Recommendations Assessment, Development and Evaluation.
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Figure 2:
Determining the strength of the recommendation. Created using the guidance provided in Andrews and colleagues.9

Table 1:

Sections of the 2012 Canadian Association of Radiologists recommendations

Section	No. of clinical and diagnostic scenarios
A. Central nervous system	15
B. Head and neck	15
C. Spine	6
D. Musculoskeletal systems	19
E. Cardiovascular	13
F. Thoracic	26
G. Gastrointestinal system	33
H. Urological, adrenal and genitourinary systems	12
I. Obstetrics and gynecology	16
J. Trauma	29
K. Cancer	68
L. Pediatrics	78
M. Breast disease	8

Table 2:

Inclusion criteria

Component	Details
Study design	Evidence-based guidelines that meet AGREE-II checklist items 7, 8 and 917^,18 Question 7. Systematic methods were used to search for evidence: Searched and named at least 1 electronic database using an electronic search strategy (e.g., MEDLINE, Embase, PubMed, CENTRAL) Question 8. The criteria for selecting the evidence are clearly described: Described a formal process for study selection; AND Reported the inclusion and exclusion criteria; OR If it is based on a systematic review but does not provide explicit methods. Question 9. The strengths and limitations of the body of evidence are clearly described: Performed critical appraisal on the included studies (e.g., risk of bias, describe study limitations); OR If it is based on a systematic review and GRADE is performed.
Population	Adults (≥ 18 yr) and/or children (< 18 yr)
Intervention/comparison	Recommendations on diagnostic imaging modalities (e.g., radiography, magnetic resonance imaging, computed tomography)
Outcomes	Diagnostic imaging recommendations for a clinical and diagnostic scenario identified by the expert panel
Timing	Published in the last 5 years (as of the date of the search)
Language	Published in English^*

Note: AGREE = Appraisal of Guidelines for Research & Evaluation, CENTRAL = Cochrane Central Register of Controlled Trials, GRADE = Grading of Recommendations Assessment, Development and Evaluation.
↵* Although the search strategy will not have a language filter, we will only include guidelines published in English. An appendix within the guideline will provide a list of potentially relevant guidelines published in other languages.