Radiologists lighten their load with online ACR index

The days of lugging around the print edition of the American College of Radiology's "Index for Roentgen Diagnosis" may be over for some radiologists. An online computer system that allows searches of the index from any Web browser has surfaced at Harvard University and Beth Israel Deaconess Medical Center.

The ACR index, published in three print editions (1955, 1961, and 1986), is the standard guideline academic radiologists use for classifying teaching cases.

Because each edition contains nearly 10,000 entries, searches can be cumbersome and time-consuming. Additionally, radiologists find it inconvenient to carry around a printed version of the index.

"In 1999, the ACR released a fourth edition of the index as a single-user CD-ROM for PCs, but most radiologists still carry the ACR book, part of the book, or copies of the book for teaching cases," said Chun-Shan Yam, Ph.D., a radiologist at Beth Israel Deaconess and Harvard.

To help lighten the load, Yam and colleagues developed a Web-based version of the index, documented in the current issue of the American Journal of Radiology (Nov. 2004, vol. 183).

With Yam's online system, users can easily navigate, search, and bookmark their commonly used indexes.

A total of 11,260 indexes (10 anatomic, 722 pathologic, 90 subanatomic, and 10,438 subpathologic) were integrated into the online system. Users can browse the entire hierarchic ACR index using cascading dropdown lists and navigate between index pages using simple mouse clicks.

"With this online access capability, the ACR index can be easily used for standardized coding of teaching cases across all sections and subspecialties in radiology," Yam said. "Without such standardization, valuable teaching cases would be lost or misplaced."

The Web-based ACR index system had been available on the Harvard and Beth Israel Deaconess intranet since March 2002. The original software and hardware configuration has required no major modifications since then.

"The system has been operating continuously 24/7 without interruption other than necessary maintenance," Yam said.

The system is currently available only to authorized users in the Beth Israel Deaconess radiology department, although other sites are advised that all Active Server Page 2.0 (Microsoft Corp.) pages described in the paper are available as open source.