Investigating the appropriateness of physician-ordered diagnostic computed tomography for patient management in a rural hospital in New South Wales, Australia.
Clin Radiol
; 74(12): 977.e17-977.e23, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31585672
ABSTRACT
AIM:
To examine the performance of "appropriate" versus "inappropriate" computed tomography (CT) and to examine whether physicians who practise in a rural hospital in NSW Australia, achieved imaging appropriateness in their ordering of diagnostic CT examinations. MATERIALS ANDMETHODS:
An audit of the electronic medical records of medical ward inpatients (during the 2016/2017 financial year) was carried out. De-identified data were extracted for all patients who had undergone diagnostic CT while on admission. Using the SPSS analytical software, chi-square tests for independence were conducted to check for difference between appropriate and inappropriate CT imaging.RESULTS:
Of all the CT procedures, 92% were found to be appropriate. Appropriate CT confirmed the provisional diagnosis in more instances than inappropriate CT (132 versus three). This observed difference was significant with a small size effect (chi-squared [1, n=362]=8.58, p=0.003, φ=0.16). Similarly, appropriate CT significantly facilitated a change in the proposed direction of care (140 versus 40) (chi-squared [1, n=362]=7.75, p=0.005, φ=0.16). In addition, appropriate CT which confirmed diagnosis, resulted in a change in the proposed direction of care as opposed to inappropriate CT (115 versus one; chi-squared [1, n=362]=8.11, p=0.004, Cramer's V=0.24).CONCLUSION:
Specialist physicians who practise in a rural hospital setting achieved CT appropriateness. Appropriate CT is beneficial to patient care. Adhering to recommended imaging guidelines is essential for achieving imaging appropriateness.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hospitais Rurais
/
Tomografia Computadorizada por Raios X
/
Procedimentos Desnecessários
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Clin Radiol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Austrália