Sardanelli Francesco, Quarenghi Matteo, Fausto Alfonso, Aliprandi Alberto, Cuppone Maria Teresa
Servizio di Radiologia, Istituto Policlinico San Donato, San Donato Milanese, Milan.
Radiol Med. 2005 Mar;109(3):229-33.
Our aim was to evaluate how many medical requests for US, CT and MR outpatients exams are inadequate.
We evaluated three series of consecutive requests for outpatients exams, distinguishing firstly the adequate from the inadequate requests. The inadequate requests were classified as: (A) absence of real indication; (B) lacking or vague clinical query; (C) absence of important information on patient's status. US requests concerned 282 patients for 300 body segments, as follows: neck (n=50); upper abdomen (n=95); lower abdomen (n=12); upper and lower abdomen (n=84); musculoskeletal (n=32); other body segments (n=27). CT requests concerned 280 patients for 300 body segments, as follows: chest (n=67); abdomen (n=77); musculoskeletal (n=94); other body segments (n=62). MR musculoskeletal requests concerned 138 patients for 150 body segments, as follows: knee (n=87); ankle (n=13); shoulder (n=28) , other body segments (n=22).
A total of 228/300 US requests (76%) were inadequate, ranging from 66% (musculoskeletal) to 86% (neck), classified as: A, 21/228 (9%); B, 130/228 (57%); C, 77/228 (34%). A total of 231/300 (77%) body CT requests were inadequate, ranging from 72% (chest) to 86% (musculoskeletal), classified as: A, 22/231(10%); B, 88/231(38%); C, 121/231(52%). A total of 124/150 (83%) MR musculoskeletal requests were inadequate, ranging from 69% (ankle) to 89% (knee), classified as: A, 12/124(10%); B, 50/124(40%); C, 62/124 (50%). No significant difference was found among the levels of inadequacy for the three techniques and among the body segments for each of the three techniques.
The majority of the medical requests for outpatient exams turned out to be inadequate. A large communication gap between referring physicians and radiologists needs to be filled.
我们的目的是评估美国、CT和MR门诊检查的医学申请中有多少是不充分的。
我们评估了三组连续的门诊检查申请，首先区分充分申请和不充分申请。不充分申请分为：(A) 无实际指征；(B) 临床询问缺失或模糊；(C) 患者状况的重要信息缺失。超声申请涉及282例患者的300个身体部位，如下：颈部（n = 50）；上腹部（n = 95）；下腹部（n = 12）；上腹部和下腹部（n = 84）；肌肉骨骼（n = 32）；其他身体部位（n = 27）。CT申请涉及280例患者的300个身体部位，如下：胸部（n = 67）；腹部（n = 77）；肌肉骨骼（n = 94）；其他身体部位（n = 62）。MR肌肉骨骼申请涉及138例患者的150个身体部位，如下：膝盖（n = 87）；脚踝（n = 13）；肩膀（n = 28），其他身体部位（n = 22）。
总共228/300例超声申请（76%）不充分，范围从66%（肌肉骨骼）到86%（颈部），分类如下：A，21/228（9%）；B，130/228（57%）；C，77/228（34%）。总共231/300例（77%）身体CT申请不充分，范围从72%（胸部）到86%（肌肉骨骼），分类如下：A，22/231（10%）；B，88/231（38%）；C，121/231（52%）。总共124/150例（83%）MR肌肉骨骼申请不充分，范围从69%（脚踝）到89%（膝盖），分类如下：A，12/124（10%）；B，50/124（40%）；C，62/124（50%）。三种技术的不充分程度之间以及每种技术的身体部位之间均未发现显著差异。
门诊检查的大多数医学申请结果是不充分的。需要填补转诊医生和放射科医生之间的巨大沟通差距。
