Unwarranted variation and overuse of diagnostic imaging is a growing problem in Norway. In April 2026, a national network for radiology was established to coordinate efforts to reduce unnecessary examinations, improve quality and ensure equal access to appropriate services throughout Norway.
Use of diagnostic imaging has increased in Norway, and substantial geographic variation has been observed in, for example, The Health Atlas produced by the Centre for Clinical Documentation and Evaluation (1). This variation cannot be explained solely by differences in clinical need and may reflect both overuse and underuse.
Health authorities are concerned about unwarranted and unexplained variation in healthcare provision and the challenges of discontinuing interventions that are not evidence-based and offer limited benefit to patients (2). Overuse is not only a resource issue; it can also be harmful to patients (3).
The Norwegian Society of Radiology was one of the first medical societies to adopt the Choosing Wisely Norway initiative. In 2017, it developed six recommendations to reduce diagnostic imaging that is rarely of clinical benefit for patients.
In 2023, Western Norway Regional Health Authority and the Centre for Clinical Documentation and Evaluation were commissioned by the Ministry of Health and Care Services to map variation and propose measures to reduce overuse of radiological services. In the resulting report (Tiltak for å redusere overforbruk og uønska variasjon i radiologitenester i Noreg), a national working group identified six key interventions considered to have the greatest potential impact (4).
Consequently, a national radiology network has now been established with representatives from all four regional health authorities, the Norwegian Radiation and Nuclear Safety Authority and the Centre for Clinical Documentation and Evaluation. The network works closely with professional bodies, particularly the Norwegian Society of Radiology, the Norwegian Society of Radiographers and the Norwegian College of General Practice. Other professional bodies and clinical communities will be involved as required.
The main task of the network is to coordinate and follow up the proposed measures aimed at reducing overuse and unwarranted variation in radiological services. A key component of its work is developing and publishing national guidance on best practice for radiology referral, including appropriate indications. The network also aims to improve communication between referring clinicians and radiology departments, help ensure that guidelines are kept up to date, and facilitate greater sharing of images and radiology reports between hospital trusts and private healthcare providers.
The national radiology network was established on 1 April 2026, and its first deliverable will be referral guidance for musculoskeletal imaging, based on existing guidelines and current knowledge. The guidance will be integrated into clinical referral systems to ensure accessibility within routine clinical workflows.
The ambitions are clear: fewer low-value investigations, reduced unwarranted variation, and better, safer and more evidence-based use of diagnostic imaging in the best interests of patients.