Heinz, S.A. (2019) Value of recommendations in reinterpretations of abdominal imaging examinations at a tertiary care center. thesis, Medicine.
Full text available on request.Abstract
Objectives: To investigate reinterpretations of abdominal imaging examinations by subspecialty radiologists with regard to 1) frequency of recommendations, 2) frequency of recommendations for additional imaging (RAIs) with associated determinants and costs, 3) frequency and determinants of compliance to these recommendations, and 4) diagnostic outcome of these recommendations. Methods: This retrospective study included 2,225 reinterpretations of abdominal imaging examinations from non-academic hospitals. Results: Recommendations were present in 273 of 2,225 reinterpretations (12.3%, 95% confidence interval [CI]: 11.0%-13.7), of which 231 were RAIs (10.4%, 95% CI: 9.2%-11.7%). Presence of an RAI was significantly associated with patient age and radiologists experience (P=0.002 for both). RAI costs per reinterpretation amounted to €31.92 (average for all RAIs), and to €19.18 (average of only those RAIs that were followed). Referring clinicians complied to 163 (53.1%, 95% CI: 47.5%-58.6%) of 307 recommendations, but no significant association with any of the examined determinants was found. Not less than 20.4% of performed recommendations lead to a malignant diagnosis, which was significantly different from recommendations that were not followed (P<0.001). Conclusions: Recommendations, and especially RAIs, are not scarce in reinterpretations of abdominal imaging examinations. RAIs appear to be affected by patients’ age and radiologists’ experience and cause non-negligible costs. Slightly more than half of all recommendations are followed by the referring clinician and lead to a malignant diagnosis many a time, but no determinants of referring clinicians’ compliance were identified. This information may be useful to clinicians, radiologists, and healthcare policy makers to make well-informed decisions on the added value and facilitation of reinterpretations.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: ` and Kwee, Thomas C.MD and Second Supervisor: and Yakar, Derya MD and University Medical Center Groningen, Medical Imaging Center |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/706 |
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