Dr. Wilkins: An expert consensus statement is similar to a practice guidance document in that a group of experts provide their opinions on a given treatment or a given disease state and how IR may be able to play a role. An expert consensus document is a way to say, “Hey, we're a bunch of experts, this is how we feel about the topic, and this is what we think should happen with this particular procedure.” Whereas a PGD is supposed to say, “Hey, if you have patients that have this, this is what you can do for them. Also, this is how you do it, how you talk to people about it and here is the evidence of support.”


What does the development process look like for documents? Dr. Wilkins: It diff ers depending on the type of document. A position statement is our society communicating how we feel about a specifi c procedure or disease state. It’s essentially saying that in disease X we feel that procedure Y would most benefi t this patient population, and here’s why.


Reporting standards documents are more applicable for if you will be doing research on a certain disease process or treatment technique, as that document provides the data points that we recommend you acquire and report, because we feel they will be the most beneficial.


CPGs involve a complete systematic review and grade of that literature. This is a very methodological process that is standardized through the medical research community. The process requires us to look at the quality of the research being done, assess it for bias and determine if the existing data supports a given topic. Then we use that clinical data to make recommendations.


With a PGD, we do a full literature review so that we can make recommendations based on literature, but we also have a panel of experts who make their own recommendations based on Delphi consensus.


Why does it take so long to develop guidelines? Dr. Wilkins: Depending on the document type, the process and development timelines can diff er. Developing clinical practice guidelines takes the longest, because it requires a complete, systematic review of the literature based on PICO questions developed by a panel. PICO questions focus on the patient, intervention, comparator and outcome, so we write the questions based on whatever the clinical problem is that we are trying to investigate. Then, a complete literature search is done based on those keywords. All those documents are then reviewed by the writing panel, and then they are given to dedicated methodologists who look through all the literature and determine the grade of its quality and ability to answer the specifi c PICO questions.


Only then is all that graded literature reviewed by the writing panel to help


make recommendations and assess the strengths of those recommendations in terms of quality of evidence. The entirety of the process takes between 12–18 months. So, it’s quite a lengthy process.


With PGDs, we aim for completion within six months. That’s another benefi t of this document type—they don’t have to be graded by methodologists, so we are able to produce them faster.


Is there anything you would like members to understand better about the diff erent types of documents or their processes? Dr. Wilkins: A lot goes into making a robust, trustworthy document that holds up over time. It requires immense behind the scenes work from our panel members and volunteers, as well as SIR staff like Kaeli Vandertulip, MBA, MS, AHIP, Jamie Collins, MSN, BSN, RN, and Liza D’Onofrio, MBA, CRA, RT(N) (ARRT), CNMT. In addition, we have illustrator Andre Ufl acker, MD, who helps bring our recommendations to life.


Despite the work required, we've been able to really ramp up our production. Currently, we are on pace to have up to fi ve documents completed before SIR 2026, and will have two CPGs coming out next year. All of this is done with the hope of getting more resources to our members, so we can support and provide value to their practices.


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What should members do if they have an idea for a document topic? Dr. Wilkins: I want them to know that I am always available. If they have an idea for a document, please reach out to guidelines@sirweb.org. The Guidelines and Statements Oversight Committee are always evaluating new ideas for documents and reassessing how we can provide value for the members.


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