Geitung J T, Skjaerstad L M, Göthlin J H
Department of Radiology, Ullevål University Hospital, Oslo, Norway.
Eur Radiol. 1999;9(4):721-3. doi: 10.1007/s003300050741.
Because chest roentgenograms are the most common radiological procedure, they represent a considerable use of resources. Because the usefulness of chest radiography is frequently disputed, it is mandatory to investigate whether or not this use of resources can be defended in terms of clinical utility. The current study was performed as an outcome analysis to assess the clinical utility of chest radiography for monitoring patients in general practice (GP). One year of chest radiography referrals from a municipality practice, comprising a total of 55 patients, were prospectively studied. Prior to the referrals, questionnaires were filled in with indications and expected results. After the examination, the radiological results were assessed regarding clinical utility. All 55 patients were carefully monitored by the same GP. The most frequent reason for referral was infectious disease. Only in 5 patients was the radiology report without value. In the 29 patients with a negative report, it was considered of value. In 7 of these 29 patients the ongoing treatment was altered. The subjective value of the radiology reports were considered to be high. The clinical utility was good, both when receiving positive and negative answers. Of special interest was the negative answers as 7 patients actually changed treatment. The clinical utility was considered high enough to justify the costs. Good access to radiology for GPs is both cost-saving and cost-effective.
由于胸部X线检查是最常见的放射学检查方法,因此它占用了大量资源。鉴于胸部X线摄影的实用性经常受到质疑,必须调查这种资源利用在临床效用方面是否合理。本研究作为一项结果分析,旨在评估胸部X线摄影在全科医疗(GP)中监测患者的临床效用。对一个市镇诊所一年来共55例患者的胸部X线检查转诊病例进行了前瞻性研究。在转诊前,填写了有关指征和预期结果的问卷。检查后,评估了放射学结果的临床效用。所有55例患者均由同一位全科医生进行密切监测。转诊的最常见原因是传染病。只有5例患者的放射学报告无价值。在29例报告为阴性的患者中,该报告被认为有价值。在这29例患者中的7例中,正在进行的治疗方案发生了改变。放射学报告的主观价值被认为很高。无论得到阳性还是阴性结果,临床效用都很好。特别值得关注的是阴性结果,因为有7例患者实际上改变了治疗方案。临床效用被认为足够高,足以证明成本的合理性。对全科医生来说,良好的放射学检查可及性既节省成本又具有成本效益。