Tay Yi Xiang, Foley Shane, Killeen Ronan, Ong Marcus E H, Chen Robert Chun, Chan Lai Peng, Mak May San, McNulty Jonathan P
Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland.
Radiography Department, Allied Health Division, Singapore General Hospital, Singapore, Singapore.
Eur Radiol. 2025 Jan;35(1):532-541. doi: 10.1007/s00330-024-10938-7. Epub 2024 Jul 13.
The objective of this systematic review was to offer a comprehensive overview and explore the associated outcomes from imaging referral guidelines on various key stakeholders, such as patients and radiologists.
An electronic database search was conducted in Medline, Embase and Web of Science to retrieve citations published between 2013 and 2023. The search was constructed using medical subject headings and keywords. Only full-text articles and reviews written in English were included. The quality of the included papers was assessed using the mixed methods appraisal tool. A narrative synthesis was undertaken for the selected articles.
The search yielded 4384 records. Following the abstract, full-text screening, and removal of duplication, 31 studies of varying levels of quality were included in the final analysis. Imaging referral guidelines from the American College of Radiology were most commonly used. Clinical decision support systems were the most evaluated mode of intervention, either integrated or standalone. Interventions showed reduced patient radiation doses and waiting times for imaging. There was a general reduction in radiology workload and utilisation of diagnostic imaging. Low-value imaging utilisation decreased with an increase in the appropriateness of imaging referrals and ratings and cost savings. Clinical effectiveness was maintained during the intervention period without notable adverse consequences.
Using evidence-based imaging referral guidelines improves the quality of healthcare and outcomes while reducing healthcare costs. Imaging referral guidelines are one essential component of improving the value of radiology in the healthcare system.
There is a need for broader dissemination of imaging referral guidelines to healthcare providers globally in tandem with the harmonisation of the application of these guidelines to improve the overall value of radiology within the healthcare system.
The application of imaging referral guidelines has an impact and effect on patients, radiologists, and health policymakers. The adoption of imaging referral guidelines in clinical practice can impact healthcare costs and improve healthcare quality and outcomes. Implementing imaging referral guidelines contributes to the attainment of value-based radiology.
本系统评价的目的是提供全面概述，并探讨影像转诊指南对患者和放射科医生等各类关键利益相关者的相关结果。
在Medline、Embase和Web of Science中进行电子数据库检索，以获取2013年至2023年发表的文献引用。检索使用医学主题词和关键词构建。仅纳入英文撰写的全文文章和综述。使用混合方法评估工具评估纳入论文的质量。对选定文章进行叙述性综合分析。
检索得到4384条记录。经过摘要、全文筛选和去除重复后，最终分析纳入了31项质量各异的研究。美国放射学会的影像转诊指南使用最为普遍。临床决策支持系统是评估最多的干预模式，包括集成式或独立式。干预措施显示患者辐射剂量降低，影像检查等待时间缩短。放射科工作量和诊断影像利用率普遍下降。随着影像转诊的适宜性、评级和成本节约的增加，低价值影像利用减少。干预期间临床疗效得以维持，且无明显不良后果。
使用基于证据的影像转诊指南可提高医疗质量和结果，同时降低医疗成本。影像转诊指南是提高放射学在医疗系统中价值的一个重要组成部分。
需要在全球范围内更广泛地向医疗服务提供者传播影像转诊指南，并同时统一这些指南的应用，以提高放射学在医疗系统中的整体价值。
影像转诊指南的应用对患者、放射科医生和卫生政策制定者有影响。在临床实践中采用影像转诊指南可影响医疗成本，提高医疗质量和结果。实施影像转诊指南有助于实现基于价值的放射学。
