Volume 49, Issue 3 Fall 2025 JVU 493-123 | Factors Affecting Accreditation in Extracranial Carotid Ultrasound Studies by the Intersocietal Accreditation Commission-Factors Affecting Accreditation in Extracranial Carotid Ultrasound Studies by the Intersocietal Accreditation Commission

Factors Affecting Accreditation in Extracranial Carotid Ultrasound Studies by the Intersocietal Accreditation Commission

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This collection of articles from the 2025 Journal for Vascular Ultrasound centers on factors affecting accreditation of extracranial carotid artery ultrasound laboratories by the Intersocietal Accreditation Commission - Vascular Testing (IAC-VT). Polak et al. conducted a retrospective analysis of 2,794 accreditation applications submitted between 2014 and 2020, finding that 58.6% received a “Delay” status before accreditation could be granted. The study identified ten significant factors associated with delays, with the three most prominent relating to the interpreting physician's adherence to diagnostic criteria, timely report availability (within 2 business days), and accuracy of interpretation. Technical factors such as image quality and appropriate Doppler waveform documentation showed shared responsibility between sonographers and physicians. The authors used a modified Delphi method to reduce bias in assigning responsibility for deficiencies, concluding that interpreting physicians play a dominant role in delays. They recommend targeted interventions focusing on physician engagement, education, and quality improvement to reduce accreditation delays and associated costs.<br /><br />Two commentary articles contextualize and reflect on these findings. Michael P. Lilly emphasizes that while vascular ultrasound is highly operator-dependent—especially relying on the sonographer’s skill and patient interaction—the diagnostic process equally depends on timely, accurate physician interpretation and organizational efficiency. He stresses that sonographers shoulder great responsibility but the overall laboratory quality relies on every phase, including medical leadership and administrative management. R. Eugene Zierler highlights the comprehensive nature of IAC-VT standards and notes that delays are often caused by interpreting physician factors. He underscores that increased physician involvement in review and reporting can improve efficiency and that accreditation programs are vital frameworks for ensuring quality. The commentaries honor Dr. Joseph Polak, the study’s lead author, recognizing his impactful contributions to vascular imaging before his passing in 2023.<br /><br />Together, these papers affirm that accreditation delays in extracranial carotid ultrasound largely stem from interpreting physician performance and organizational factors, not solely from sonographer technical skill. Improving physician adherence to diagnostic criteria, accuracy, and prompt reporting, alongside continued sonographer training and quality assurance, are essential to enhancing vascular laboratory accreditation success and patient care quality.

Keywords

extracranial carotid artery ultrasound

IAC-VT accreditation

interpreting physician adherence

diagnostic criteria compliance

timely report availability

interpretation accuracy

sonographer technical skill

vascular laboratory quality

Delphi method analysis

vascular ultrasound accreditation delays