Gottlieb R H, Hollenberg G M, Fultz P J, Rubens D J
Department of Radiology, University of Rochester School of Medicine and Dentistry, NY 14642, USA.
Acad Radiol. 1997 Mar;4(3):217-21. doi: 10.1016/s1076-6332(05)80294-6.
The authors evaluated radiologic consultation affecting resident physician ordering of relatively expensive imaging studies.
Requisitions (n = 180) for expensive imaging studies from three general medicine floors (two consultation floors, one control floor) were prospectively evaluated. Information on the requisitions was classified as appropriate, inappropriate, or undecided if insufficient information was provided. On the consultation floors, but not the control floor, the medical residents were contacted about all studies initially considered inappropriate or undecided before they were performed.
Nine of 119 requisitions (7.6%) from the consultation floors were considered inappropriate. In three studies (2.5%) the imaging evaluation was modified as the result of the interaction with the radiologist. There was no significant difference in the total number of radiologic studies or percentage of the total that were expensive imaging studies when comparing the consultation floors with the control floor.
Radiologic consultation on expensive imaging studies through routine review of requisitions did not significantly change their use by house staff.
作者评估了放射学会诊对住院医师开具相对昂贵影像检查申请单的影响。
前瞻性评估了来自三个普通内科楼层(两个会诊楼层,一个对照楼层)的昂贵影像检查申请单(n = 180)。如果提供的信息不足,申请单信息被分类为适当、不适当或不确定。在会诊楼层,而非对照楼层,在所有最初被认为不适当或不确定的检查进行之前,与住院医师就这些检查进行了沟通。
会诊楼层的119份申请单中有9份(7.6%)被认为不适当。在三项检查(2.5%)中,与放射科医生沟通后影像评估被修改。将会诊楼层与对照楼层进行比较时,放射学检查的总数或昂贵影像检查在总数中所占的百分比没有显著差异。
通过对申请单进行常规审查对昂贵影像检查进行放射学会诊,并未显著改变住院医师对其的使用情况。