Alanazi Ali Hasayan, Cradock Andrea, Toomey Rachel, Galligan Marie, Ryan John, Stowe John, Rainford Louise
Radiography and Diagnostic Imaging, University College Dublin, Dublin, Ireland.
School of Medicine, University College Dublin, Dublin, Ireland.
Int J Gen Med. 2022 Jul 28;15:6315-6324. doi: 10.2147/IJGM.S366653. eCollection 2022.
To determine how radiologists across health-care jurisdictions internationally assess the appropriateness and urgency levels of lumbar spine Magnetic Resonance Imaging MRI referrals.
Clinical information was extracted from 203 lumbar spine MRI referrals. Texts were divided into 10 datasets and embedded into a software to facilitate the classification process. Participant radiologists were recruited at the Image Perception Lab, at the Radiological Society of North America Congress, 2019 and through the institution radiology network. Radiologists were asked if they use referral guidelines in their practices. Radiologists assigned appropriateness and urgency levels based on the referral text. Appropriateness level descriptors were: indicated, indicated but needs more information or not indicated. Urgency levels were categorized: urgent, semi-urgent, or not urgent. All cases containing neurological symptoms with/without red flags were extracted and exact agreement between radiologists' responses on the indication status was calculated.
Seventy radiologists from 25 countries participated; 42% of participants indicated non-use of referral guidelines. Poor-moderate radiology agreements were recorded for appropriateness and referral urgency level decisions. 79.6% of responses indicated that cases containing neurological symptoms with/without red flags were indicated for scanning.
Despite referral guidelines promotion, nearly half of participants stated non-usage. Subsequently, a varied agreement levels were found in assigning the appropriateness of the referrals. Appropriateness of referrals with neurological symptoms (with/without red flags) recorded good agreement.
确定国际上不同医疗保健辖区的放射科医生如何评估腰椎磁共振成像（MRI）转诊的适宜性和紧急程度。
从203例腰椎MRI转诊病例中提取临床信息。文本被分为10个数据集并嵌入到一个软件中以促进分类过程。参与研究的放射科医生是在2019年北美放射学会大会的图像感知实验室以及通过机构放射科网络招募的。研究询问放射科医生在其工作中是否使用转诊指南。放射科医生根据转诊文本确定适宜性和紧急程度。适宜性水平描述词为：有指征、有指征但需要更多信息或无指征。紧急程度分为：紧急、半紧急或不紧急。提取所有包含有或无警示信号的神经症状的病例，并计算放射科医生对指征状态的回答之间的精确一致性。
来自25个国家的70名放射科医生参与了研究；42%的参与者表示未使用转诊指南。在适宜性和转诊紧急程度的决策方面记录到放射科医生之间存在中度偏低的一致性。79.6% 的回答表明，包含有或无警示信号的神经症状的病例有扫描指征。
尽管一直在推广转诊指南，但近一半的参与者表示未使用。随后，在确定转诊的适宜性方面发现了不同程度的一致性。有神经症状（有/无警示信号）的转诊适宜性记录显示一致性良好。
