Loop J W, Lusted L E
AJR Am J Roentgenol. 1978 Jul;131(1):173-9. doi: 10.2214/ajr.131.1.173.
Questions about costs and benefits of radiologic diagnostic methods have lead to the formation of a standing American College of Radiology Committee on Efficacy. In the past several years this committee has defined a hierarchy of efficacies associated with radiographic procedures and developed methods for assigning a numerical value to diagnostic efficacy. A national study of common x-ray examinations in the emergency setting has been conducted. These studies suggest that diagnostic thinking of clinicians was influenced by the results of the x-ray procedures they requested in more than 92% of cases. Medicolegal consideration were a prime concern of the clinician only 6% of the time overall when selecting the most frequent radiologic procedures conducted in hospitals. Considerable uncertainty about clinical diagnoses was typically present at the time radiologic examinations were requested; three-fourths of the time the most important diagnosis under consideration was judged to be less likely after x-ray examination than before. About one-eighth of the time the radiographic information focused attention on a new "most important" diagnosis. The committee plans further studies to include other imaging modalities and practive settings.
关于放射诊断方法的成本和效益问题，促使美国放射学会常设效能委员会的成立。在过去几年里，该委员会确定了与放射学程序相关的效能等级，并开发了为诊断效能赋予数值的方法。一项针对急诊环境中常见X射线检查的全国性研究已经开展。这些研究表明，在超过92%的病例中，临床医生的诊断思维受到他们所要求的X射线检查结果的影响。在选择医院中最常用的放射学程序时，法医学考量总体上仅在6%的时间里是临床医生的首要关注点。在请求进行放射学检查时，通常存在相当大的临床诊断不确定性；四分之三的情况下，经X射线检查后，正在考虑的最重要诊断被判定比检查前可能性更小。约八分之一的时间里，放射学信息将注意力集中在一个新的“最重要”诊断上。该委员会计划进一步开展研究，以纳入其他成像模态和实际应用场景。
