Almodóvar Antonio, Ronda Elena, Flores Raquel, Lumbreras Blanca
General University Hospital of Elche, Elche, Spain.
CIBERESP, Madrid, Spain.
Insights Imaging. 2022 Aug 4;13(1):126. doi: 10.1186/s13244-022-01263-y.
To evaluate the appropriateness of imaging tests associated with radiation in the field of otolaryngology according to the available recommendations, and to estimate the effective radiation dose associated.
Cross-sectional epidemiological study of the totality of the imaging test requests carried out by two Spanish hospitals (n = 1931). We collected the following information: patient demographic data, type of imaging test, imaging tests referred in the previous 12 months, referrer department and diagnostic suspicion. In accordance with the available guidelines, we considered the requests: (a) Appropriate; (b) Inappropriate; (c) Not adequately justified; (d) Not included in the guidelines. We calculated the prevalence of each category and their variation according to the different variables. Collective and per capita effective dose were calculated for each category.
Of the 538 requests, 42% were considered appropriate, 34.4% inappropriate, 11.9% not adequately justified and 11.7% not included in the guidelines. Imaging tests requested by general partitioners (aOR: 0.18; 95% CI: 0.06-0.50) and clinical departments (aOR: 0.27; 95% CI: 0.11-0.60) were less likely to be considered appropriate than those requested by the Otolaryngology department. Patients with a diagnosis suspicion of tumour pathology were more likely to have a requested imaging test classified as appropriate (aOR: 7.12; 95% CI: 3.25-15.61). The cumulative effective dose was 877.8 mSv, of which 40% corresponded to tests classified as inappropriate.
A high percentage of imaging tests are considered as inappropriate in the field of otolaryngology, with a relevant frequency of associated effective radiation dose. Type of department, the diagnostic suspicion and the type of imaging tests were variables associated to the inappropriateness of the test.
根据现有建议评估耳鼻喉科领域与辐射相关的影像检查的适宜性，并估算相关的有效辐射剂量。
对两家西班牙医院进行的所有影像检查申请进行横断面流行病学研究（n = 1931）。我们收集了以下信息：患者人口统计学数据、影像检查类型、前12个月内转诊的影像检查、转诊科室和诊断怀疑。根据现有指南，我们将申请分为：（a）适宜；（b）不适宜；（c）理由不充分；（d）未纳入指南。我们计算了每个类别的患病率及其根据不同变量的变化。计算了每个类别的集体和人均有效剂量。
在538份申请中，42%被认为适宜，34.4%不适宜，11.9%理由不充分，11.7%未纳入指南。普通科室（调整后比值比：0.18；95%置信区间：0.06 - 0.50）和临床科室（调整后比值比：0.27；95%置信区间：0.11 - 0.60）申请的影像检查被认为适宜的可能性低于耳鼻喉科申请的检查。诊断怀疑为肿瘤病理的患者，其申请的影像检查更有可能被分类为适宜（调整后比值比：7.12；95%置信区间：3.25 - 15.61）。累积有效剂量为877.8 mSv，其中40%对应于被分类为不适宜的检查。
在耳鼻喉科领域，很大比例的影像检查被认为不适宜，且相关有效辐射剂量的频率较高。科室类型、诊断怀疑和影像检查类型是与检查不适宜性相关的变量。
