The Canadian Association of Radiologists (CAR) develops national referral guidelines to support informed, evidence-based decision-making by healthcare providers who request diagnostic imaging. These guidelines aim to ensure that patients receive the most appropriate imaging exam at the right time, enhancing diagnostic value and improving health outcomes.
Current Guidelines
As of March 10, 2025, referral recommendations across all 13 guideline sections are complete and available in both English and French. Summary tables are provided in Appendix 3A and 3B of the full PDF documents.
The guideline development protocol was published in CMAJ Open in March 2023.
Collaborative Development
Initiated in 2021 with support from the Canadian Medical Association, the referral guidelines are being integrated into electronic Clinical Decision Support (CDS) systems to streamline access at the point of care. The CAR collaborates with a wide range of professional organizations—including the Canadian Association of Emergency Physicians, the College of Family Physicians of Canada, the Society of Rural Physicians of Canada, Choosing Wisely, and the Nurse Practitioner Association of Canada—to ensure multidisciplinary input and broad clinical relevance.
A dedicated CAR Referral Guidelines Working Group, co-chaired by Dr. Ryan Margau and Dr. Paul Pageau, provides national leadership in developing and peer-reviewing the recommendations, with contributions from 16 experts across Canada.
Mandate
The CAR’s referral guidelines are designed to:
- Assist referring providers in selecting the most appropriate imaging modality
- Improve the quality and consistency of referrals
- Reduce unnecessary imaging and promote patient-centered care
Beyond integration into CDS tools, the guidelines are publicly available to support effective communication across the care continuum.
Foundation of the Work
The CAR laid the groundwork for these national guidelines through two symposia held in 2018, focused on imaging referral appropriateness and the adoption of CDS systems. These events established a collaborative foundation that continues to guide development today.
