Academic Journal
Computed tomography referral guidelines adherence in Europe: insights from a seven-country audit
| Τίτλος: | Computed tomography referral guidelines adherence in Europe: insights from a seven-country audit |
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| Συγγραφείς: | Clara Singer, Mor Saban, Osnat Luxenburg, Lucia Bergovoy Yellin, Monika Hierath, Jacob Sosna, Alexandra Karoussou-Schreiner, Boris Brkljačić |
| Πηγή: | Eur Radiol |
| Στοιχεία εκδότη: | Springer Science and Business Media LLC, 2024. |
| Έτος έκδοσης: | 2024 |
| Θεματικοί όροι: | Male, Adult, Adolescent, Referral and Consultation / statistics & numerical data, Young Adult, Practice Patterns, Physicians' / statistics & numerical data, Humans, Practice Patterns, Physicians', Child, Referral and Consultation, Aged, Aged, 80 and over, Medical Audit, Infant, Referral and Consultation / standards, Middle Aged, Europe, Imaging Informatics and Artificial Intelligence, Tomography, X-Ray Computed / standards, Child, Preschool, Practice Guidelines as Topic, Guideline Adherence / statistics & numerical data, Female, Guideline Adherence, Tomography, X-Ray Computed / statistics & numerical data, Tomography, X-Ray Computed |
| Περιγραφή: | Background Ensuring appropriate computed tomography (CT) utilization optimizes patient care while minimizing radiation exposure. Decision support tools show promise for standardizing appropriateness. Objectives In the current study, we aimed to assess CT appropriateness rates using the European Society of Radiology (ESR) iGuide criteria across seven European countries. Additional objectives were to identify factors associated with appropriateness variability and examine recommended alternative exams. Methods As part of the European Commission-funded EU-JUST-CT project, 6734 anonymized CT referrals were audited across 125 centers in Belgium, Denmark, Estonia, Finland, Greece, Hungary, and Slovenia. In each country, two blinded radiologists independently scored each exam’s appropriateness using the ESR iGuide and noted any recommended alternatives based on presented indications. Arbitration was used in case auditors disagreed. Associations between appropriateness rate and institution type, patient’s age and sex, inpatient/outpatient patient status, anatomical area, and referring physician’s specialty were statistically examined within each country. Results The average appropriateness rate was 75%, ranging from 58% in Greece to 86% in Denmark. Higher rates were associated with public hospitals, inpatient settings, and referrals from specialists. Variability in appropriateness existed by country and anatomical area, patient age, and gender. Common alternative exam recommendations included magnetic resonance imaging, X-ray, and ultrasound. Conclusion This multi-country evaluation found that even when using a standardized imaging guideline, significant variations in CT appropriateness persist, ranging from 58% to 86% across the participating countries. The study provided valuable insights into real-world utilization patterns and identified opportunities to optimize practices and reduce clinical and demographic disparities in CT use. Key Points Question Largest multinational study (7 EU countries, 6734 CT referrals) assessed real-world CT appropriateness using ESR iGuide, enabling cross-system comparisons. Findings Significant variability in appropriateness rates across institution type, patient status, age, gender, exam area, and physician specialty, highlighted the opportunities to optimize practices based on local factors. Clinical relevance International collaboration on imaging guidelines and decision support can maximize CT benefits while optimizing radiation exposure; ongoing research is crucial for refining evidence-based guidelines globally. |
| Τύπος εγγράφου: | Article Other literature type |
| Περιγραφή αρχείου: | application/pdf |
| Γλώσσα: | English |
| ISSN: | 1432-1084 |
| DOI: | 10.1007/s00330-024-11083-x |
| Σύνδεσμος πρόσβασης: | https://pubmed.ncbi.nlm.nih.gov/39384590 https://urn.nsk.hr/urn:nbn:hr:105:295611 https://doi.org/10.1007/s00330-024-11083-x |
| Rights: | CC BY |
| Αριθμός Καταχώρησης: | edsair.doi.dedup.....ae8a690be8e9668c468bf9fcc55d6bc5 |
| Βάση Δεδομένων: | OpenAIRE |
| ISSN: | 14321084 |
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| DOI: | 10.1007/s00330-024-11083-x |