Appropriateness of Radiology Test Requests by an Emergency Department: A Retrospective Study

Authors

  • Rute Martins Serviço de Radiologia. Centro Hospitalar Universitário do Algarve. Faro e Portimão. Algarve Biomedical Center. Faro.
  • Pedro Raimundo Departamento de Ciências Biomédicas e Medicina. Universidade do Algarve. Faro.
  • Pedro Alves Serviço de Radiologia. Centro Hospitalar Universitário do Algarve. Faro e Portimão. Algarve Biomedical Center. Faro.
  • Rodrigo Monteiro Serviço de Radiologia. Centro Hospitalar Universitário do Algarve. Faro e Portimão. Algarve Biomedical Center. Faro.
  • Luís Duarte Silva Serviço de Radiologia. Centro Hospitalar Universitário do Algarve. Faro e Portimão. Algarve Biomedical Center. Faro.
  • André Gomes Serviço de Radiologia. Centro Hospitalar Universitário do Algarve. Faro e Portimão. Algarve Biomedical Center. Faro.
  • Graça Afonso Serviço de Radiologia. Centro Hospitalar Universitário do Algarve. Faro e Portimão. Algarve Biomedical Center. Faro.

DOI:

https://doi.org/10.20344/amp.12075

Keywords:

Diagnostic Imaging/statistics & numerical data, Emergency Service, Hospital, Practice Patterns, Physicians, Radiology Department, Unnecessary Procedures

Abstract

Introduction: Imaging tests are essential for diagnosis in the emergency context and convey clinical information that is essential to assess the appropriateness of the tests and improve their interpretation. Therefore, we aimed to analyze the imaging tests requested by the Emergency Department in a district hospital.
Material and Methods: We retrospectively analyzed computed tomography and ultrasound scans requested by the Emergency Department at the Centro Hospitalar Universitário do Algarve and considered the following variables: requested test, clinical information provided (complete/incomplete), appropriateness of the test (appropriate/inappropriate), outcome (presence/absence of relevant findings) and findings related to the clinical information (yes/no). Pearson’s chi-squared and odds ratio association tests were used to evaluate the statistical association between the variables.
Results: Out of 1427 requests, only 219 (15.3%) were considered to have complete clinical information. Nonetheless, 1075 (75.3%) requests were considered appropriate. Relevant findings were present in about one-third (n = 453; 31.7%) and most of these findings were related to the clinical context (n = 410; 90.5%). There was a significant association between test appropriateness and the presence of relevant findings in the test (p < 0.001). The odds ratio of having a relevant finding was 5.0 times higher in the tests considered appropriate when compared with those classified as inappropriate (CI = 3.4 - 7.3; p < 0.001).
Discussion: The fact that appropriate tests potentiate the probability of having a relevant finding emphasizes the importance of defining guidelines so that only the adequate tests are performed.
Conclusion: Creating guidelines should improve the appropriateness of imaging tests requested in the Emergency Department, yielding their result, with the consequent rationalization of the available resources.

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Published

2020-01-03

How to Cite

1.
Martins R, Raimundo P, Alves P, Monteiro R, Silva LD, Gomes A, Afonso G. Appropriateness of Radiology Test Requests by an Emergency Department: A Retrospective Study. Acta Med Port [Internet]. 2020 Jan. 3 [cited 2024 Oct. 16];33(1):7-14. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12075

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Section

Original