IRQ Articles

Quality improvement column 

04-22-2019 03:37 PM

SIR standards authors describe their experiences

Alda Tam, MD, FSIR  Spring 2019

Standards documents are developed to help providers achieve high-quality outcomes and improve patient safety. The previous installment of this series in the Fall 2018 IRQ described the development of SIR’s new methodology1 and the recent changes to SIR’s standards process. To provide greater insight into the new standards process, we asked current authors to share their experience with writing standards documents for IR. This is the second in a series of planned articles dedicated to the changes within the SIR Standards Division. Stay tuned for further information in coming months.

1. Why did you become involved with writing standards documents?

Douglas Beall, MD: To help facilitate pathways to optimize patient care.

David Sacks, MD, FSIR: I was invited to work on standards in 1988 by a mentor in private practice. It was a way to contribute to SIR as a volunteer.

Jon C. Davidson, MD, FSIR: I have been involved with writing standards documents for almost 10 years now. It has been one of the most rewarding parts of my career, because the process has forced me to become aware of and knowledgeable with all the up-to-date evidence-based research. It is a wonderful and incredibly rewarding experience!

Dan Patel, MD: SIR is the primary specialty society for interventional radiologists and as such I felt I needed to volunteer in some way. Initially I became involved with the Standards Committee because it was an opportunity to speak with and learn from various SIR members from around the world. Together we could discuss various topics, look at the data, and attempt to generate practice principles that should result in high-quality medical care for our colleagues.

2. Why are standards important to IRs and how they practice?

DB: They provide information that is additive to the existing literature including expert opinion and formal consensus information.

DS: Interventional radiologists pride ourselves in being able to provide minimally invasive, image-guided care better than others. Standards are the mechanism to define what are acceptable outcomes and to hold ourselves and others accountable.

JD: Standards are vital for an IR practice, as they basically standardize our procedures and workflow with expert consensus and evidence-based methodology.

DP: Standards are important because it provides a framework for members and nonmembers alike to be able to reference evidence-based guidelines put forth by their society. We all want to practice high-quality, reliable care, with the goal of patient safety in mind. The documents set forth by the Standards Committee aid in ensuring that we do so.

3. What do you envision as the future of standards?

DB: A more comprehensive set of standards to include topics that are more arcane and esoteric.

DS: Standards will grow in quality. Literature reviews and recommendations will be graded for the quality of evidence and strength of recommendation. SIR will write documents on clinical practice recommendations, in addition to reporting standards and quality benchmarks.

JD: The future of standards includes using more and more evidence-based data. In addition, utilizing resources from other medical specialties will be vital. For example, we have utilized a hematologist and a vascular medicine physician as part of our writing group for the coagulation guidelines manuscript.

DP: As more standards documents get published, I hope members realize how far we have collectively come as a society. We are gathering more evidence-based data and distributing it as concisely as possible. With that said, there are areas where we are lacking and I envision, with the help of Standards, members seeing where we need to collect more data and generate better quality studies.

4. What is one thing members interested in joining a writing group should know?

DB: That these standards are not intended to be legal standards upon which legal decisions are based.

DS: Writing is about patient care. Leave your ego at home. Do your work by when you said it would be done and people will love you.

JD: The one thing members interested in joining a standards writing group should know is that it will be incredibly rewarding for your career.

DP: When joining a writing group you get to know and connect with a variety of SIR members throughout the years (in person, by email and over conference calls). These relationships can last long after the writing group has put forth its document. This past year, we got to know Ido Weinberg, a leader in vascular medicine, and Ravi Sarode, a leader in transfusion medicine and hemostasis, when putting together the 2019 consensus guidelines on the Periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions. The SIR staff we have worked with in Standards (Lizzy Himes, Zuhal Haidari and Debbie Katsarelis) are also great and keep the process running smoothly.

[1] Tam, A.L., L. Findeiss, M.D. Dake, et al., Standards 2.0: Methodology Update. J Vasc Interv Radiol, 2018. 29(10): p. 1347-1349.

Standards author bios

Douglas Beall, MD, is from the department of radiology at the Oklahoma Spine Hospital, Oklahoma City. His recent work showcases rigorous evidence-based methodology to define clinical care pathways for vertebral fragility fractures. He is also the lead investigator of the SIR Foundation–supported registry on vertebral compression fractures and has submitted the results for publication.

David Sacks, MD, FSIR, is from the department of interventional radiology at The Reading Hospital and Medical Center, Pennsylvania. He has a long tenure of service on the Standards Committee and has served as the Standards Division councilor. His published work has been instrumental in defining the role of IR in neuro and stroke cases and he continues to develop standards documents with SIR.

Jon Davidson, MD, is the fellowship director for interventional radiology at University Hospitals Cleveland Medical Center. He serves as a member of the Standards Committee and served on the former Position Statement Subcommittee. He is currently the lead author of part I of SIR’s updated anticoagulation guidelines, which will be published in an upcoming issues of JVIR.

Indravadan (Dan) Patel, MD, is the division chief of interventional radiology at University Hospitals Cleveland Medical Center. He has served on the Standards Committee and has been the lead author on several published SIR standards documents. He is currently the lead author of Part II of SIR’s updated anticoagulation guidelines, which will be published in an upcoming issue of JVIR.

About Standards Division writing groups

What are the different roles within a writing group?

Writing group roles include:

  • Performing an in-depth database literature search to find published research
  • Assessing and grading the evidence used to form recommendations
  • Writing a section of the draft document
  • Reviewing the draft document for content and accuracy


Interested in joining a writing group?

Anyone can join a writing group regardless of experience level or membership with SIR. Those interested can contact SIR staff for more information or contact the lead author directly. SIR encourages multidisciplinary collaboration for documents whose topics overlap with other specialties; this provides a broader perspective and knowledge base to inform best practice recommendations.


Interested in joining the SIR Standards Committee?

Applications to join the Standards Committee open in the fall and are available in the “Volunteer Opportunities” section on SIR Connect ( All career levels are welcome to apply for the Standards Committee, whose members serve 3-year terms. Members are organized into workgroups based on their areas of expertise. Responsibilities can include:

  • Serving on a writing group
  • Reviewing current, published SIR standards every 3–5 years to ensure all recommendations and literature are still valid
  • Updating literature and recommendations, as needed, of previously published SIR standards
  • Reviewing SIR draft documents for completeness and accuracy before publication
  • Reviewing draft documents of external organizations to ensure that IRs are accurately represented

New topics prioritized for standards development in 2019 are now available on the Standards webpage ( in the spring. A full listing of SIR’s published standards documents can be found at


Connect with SIR