Developing an Appropriateness Criteria for Knee MRI Using the Rand Appropriateness Method (RAM)-2013

Document Type : RESEARCH PAPER


1 Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

2 Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Orthopedic Research Center, Mashhad University Of Medical Sciences, Mashhad, Iran

4 Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Orthopedic Surgery, North Khorasan University of Medical Sciences, Bojnurd, Iran

6 Health Sciences Research Center, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

7 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

8 Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran


Knee pain is one of the most common reasons patients visit their physician. In this regard Magnetic Resonance Imaging (MRI) is the tool of preference for diagnosis. The aim of this study was to determine appropriate guidelines for knee MRI administration using the RAND Appropriateness Method (RAM)-2013
This qualitative study was done in the Mashhad University of Medical Sciences in 2013. The most appropriate approved knee MRI administration clinical guidelines were evaluated using Guidelines Evaluation and Research Appraisal (AGREE). Panel members consisting of six orthopedic and three rheumatologic doctors gave scores ranging from 1 to 9 for each scenario. The indications were grouped as appropriate, equivocal and inappropriate. Data were analyzed by descriptive statistics and SPSS ver. 18 software.
Sixty-three scenarios were extracted from the guidelines and then the scenarios were evaluated in 26 indications. Thirty-two (50.79%) cases were considered appropriate, 12 (19.04%) cases uncertain and 19 (30.1%) cases inappropriate.
The RAND appropriateness method is helpful in identifying the opinion of stakeholders in health care systems. Moreover, making practical use of clinical guidelines can improve patients’ quality of care and prevent unnecessary costs.


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