Delgado Nicolás M A, Peces Morate F J
Especialistas en Medicina Familiar y Comunitaria, Centro de Salud Embajadores, INSALUD, Madrid.
Aten Primaria. 1996 Jan;17(1):52-6.
To analyse the quality of requests in primary care for radiological investigations, by determining both their effectiveness and modifications in the doctors' therapeutic approach and diagnostic opinion caused by the radiological findings.
Longitudinal, retrospective study.
The Embajadores 1 Primary Care team (PCT), Madrid, during 1993.
203 radiologies on a significant sample of the PCT's catchment population with a clinical history.
Radiology was requested for 12% of patients seen: males 39.40% and women 60.59%. Average age was 56.64 +/- 1.41. Commonest requests were for: bone (41.87%), thorax (25.12%), abdominal ecography (9.36%) and digestive system (8.37%). Pathology was discovered in 67.98% of cases, with these results considered relevant in 26.60%. The radiological findings caused 18.72% of doctors to change their therapeutic approach or diagnostic opinion. The radiological investigations with most relevant findings were: mammographies (38.46%), barium meals (35.29%) and abdominal ecographies (31.57%).
Bone and thoracic radiologies account for almost 70% of requests. Despite the high percentage of pathological radiographies, only 19% of the x-rays caused any change in the doctor's attitude, which makes us think the correct indication for each case must be analysed.
通过确定基层医疗中放射学检查申请的有效性以及放射学检查结果对医生治疗方法和诊断意见的改变，分析放射学检查申请的质量。
纵向回顾性研究。
1993年马德里Embajadores 1初级保健团队（PCT）。
对PCT服务范围内有临床病史的大量样本进行了203次放射学检查。
在就诊患者中，12%的患者接受了放射学检查：男性占39.40%，女性占60.59%。平均年龄为56.64±1.41岁。最常见的检查申请部位为：骨骼（41.87%）、胸部（25.12%）、腹部超声（9.36%）和消化系统（8.37%）。67.98%的病例发现了病变，其中26.60%的结果被认为具有相关性。放射学检查结果使18.72%的医生改变了治疗方法或诊断意见。发现最具相关性结果的放射学检查为：乳房X光检查（38.46%）、钡餐检查（35.29%）和腹部超声检查（31.57%）。
骨骼和胸部放射学检查申请占近70%。尽管病理性放射学检查的比例很高，但只有19%的X光检查使医生的态度发生了改变，这促使我们认为必须对每个病例的正确检查指征进行分析。
