Developing Appropriate Indications for Prescriptions of Brain MRI using RAND Appropriateness Method

Background: Evidence Based Medicine can be define as the process of systematically finding, critically appraising, and using recently published researches as a basis for making decisions regarding individual patients.One of the most prevalent MRI procedures is Brian MRI. This study aimed to identifying and developing appropriate indications for prescriptions of Brain MRI in Iran. Methods: This is a consensus based study using one of the practical methods, RAND Appropriateness Method. The study sample was among experts in the treatment and diagnostic field of brain disorders. The experts consisted of nine specialists: Four neurosurgeons and five neurologists, all of whom were faculty members and worked in educational hospitals. The list of indications and scenarios sent to 9 experts for scoring. They scored the scenarios according to RAM (Rand Appropriateness Method) instruction. Results: A total of 104 indications and scenarios were extracted. After that, Finally80scenarios fall in the category of appropriate scenarios, 20 in uncertain and4 in the category of inappropriate scenarios. Conclusion: Currently a huge number of medical imaging prescriptions may be unnecessary in Iran and there is need for developing clinical practice guidelines. The findings of this study can be used for developing national guidelines, conducting research to assess whether the criteria are followed in practice and whether their application can curb the growing rate of unnecessary care in all countries. In Iran, a limited amount of resources are allocated to the health sector.