Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Australia.
Department of Diagnostic Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
J Med Radiat Sci. 2022 Dec;69(4):421-430. doi: 10.1002/jmrs.607. Epub 2022 Jul 14.
Inadequate clinical information in medical imaging requests negatively affects the clinical relevance of imaging performed and the quality of resultant radiology reports. Currently, there are no published Australian guidelines on what constitutes adequate clinical information in computed tomography (CT) requests. This study aimed to determine specific items of clinical information radiologists require in CT requests for acute chest, abdomen and blunt trauma examinations, to support optimal reporting.
A panel of 24 CT-reporting consultant radiologists participated in this e-Delphi consensus study. Panellists undertook multiple online survey rounds of open-ended, dichotomous and Likert scale questions, receiving feedback following each. Round 1 responses formulated lists for each CT examination. Round 2 set a threshold of 80% agreement after dichotomous scoring. Round 3 accepted items which averaged 4 or more on a 5-point Likert scale. Round 4 required panellists to rank items within the aggregated, accepted lists, based on panellists' perceived level of usefulness.
The large numbers of round 1 items (chest: 101, abdomen: 76, blunt trauma: 80) were rationalised and grouped into categories to facilitate efficiency during subsequent rounds. Twenty-three chest, 24 abdomen and 17 blunt trauma items met the 80% agreement threshold in round 2. Items below threshold were included in round 3; numbering 44, 19 and 23 for chest, abdomen and blunt trauma, respectively. Through the e-Delphi process, we formulated clinical information criteria standards for three CT types.
The developed standards will guide Australian referrers in providing adequate clinical information in CT requests, to support optimal reporting, diagnosis and treatment.
医学影像学检查申请中提供的临床信息不足会影响影像学检查的临床相关性和放射科报告的质量。目前，澳大利亚尚无关于 CT 请求中包含哪些充分临床信息的相关指南。本研究旨在确定放射科医师在进行急性胸部、腹部和钝性创伤 CT 检查时，对 CT 请求中所需的具体临床信息，以支持进行最佳报告。
24 名 CT 报告顾问放射科医师参与了这项电子德尔菲共识研究。专家小组进行了多次在线开放式、二分类和 Likert 量表问题调查，每次调查后都收到反馈。第一轮的回答为每项 CT 检查列出了清单。第二轮根据二分类评分设置了 80%的一致性阈值。第三轮接受了平均得分为 5 分制 4 分或以上的项目。第四轮要求小组成员根据小组对有用性的感知程度，对汇总的、被接受的清单中的项目进行排名。
第一轮的大量项目（胸部：101 个，腹部：76 个，钝性创伤：80 个）进行了合理化和分组，以便在后续轮次中提高效率。在第二轮中，有 23 个胸部、24 个腹部和 17 个钝性创伤项目达到了 80%的一致性阈值。低于阈值的项目被纳入了第三轮，数量分别为 44、19 和 23 个，用于胸部、腹部和钝性创伤。通过电子德尔菲法，我们为三种 CT 类型制定了临床信息标准。
所制定的标准将指导澳大利亚的临床医生在 CT 请求中提供充分的临床信息，以支持进行最佳报告、诊断和治疗。
