Dear Editor,

We read the editorial entitled ‘Accreditation in Interventional Radiology: Why it Matters and Why we Sought IASIOS Certification’ with great interest [1]. First of all, we would like to congratulate them on IASIOS accreditation, a unique tool to improve interventional oncology services around the globe. However, we believe that the authors’ implication from a systemic review should be clarified, as it might lead to ambiguity for interested readers. They stated that ‘accreditation does have a net positive effect on patient safety, culture, and efficiency; however, it can enhance institutional and clinical performance when appropriately applied’.

Indeed, Hussein et al. [2] reported a positive accreditation effect on process-related performance measures, safety culture, hospital efficiency, and patient length of stay. Due to the heterogeneity of the data, they had inconclusive evidence on causality. On the other hand, a positive effect was found barely 55% of the contained studies [2].

Accreditation was introduced into healthcare services about two decades ago to ensure the quality and safety of patient care. Early studies demonstrated that it could promote professional development and change [3]. Although it is generally taken as a part of institutional accreditation, specialty or disease-specific accreditations are also present [4]. In parallel with the authors, we think that modernizing accreditation and moving towards specific needs could be beneficial for consistent and sustainable results.