ArticleEuropean radiology2018
Radiation protection: Factors influencing compliance to referral guidelines in minor chest trauma.
Article in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 5 citations in OpenAlex.
- Knowledge and perceptions of ionising radiation among Croatian general practitioners: is there cause for concern?Arhiv za higijenu rada i toksikologiju · 2025Article
- Are referral guidelines for CT examinations addressing all clinical scenarios? A comparison of EURO-2000 Guidelines and ESR iGuide.European radiology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo test the hypothesis that referral guidelines are not sufficiently known by prescribers and that medico-legal concerns could influence the prescription of radiographs in minor chest trauma.
methodsWe submitted a questionnaire including a typical clinical history and questions on reasons for prescribing radiographs of the ribs in minor chest trauma to 112 prescriptors (33 residents, 18 surgeons, 7 internists, 24 general practitioners and 30 ER physicians). All accepted to participate. Comparisons were performed by Fisher's exact test followed by a post-hoc analysis and by a McNemar test.
resultsFifty-eight percent of prescriptors proposed rib radiographs, most (89%) being unaware of the guidelines. Only 11% of them changed their intention to order radiographs after information on referral guidelines and radiation dose (P=0.057). The mean dose delivered by rib radiographs was 38 times higher than that of a chest X-ray. Legal and medico-legal concerns (requirements from insurance policies and avoidance of lawsuits) were the main reasons for requesting radiographs.
conclusionUnsharpness of guidelines in addition to social and medico-legal issues, rather than medical reasons or the lack of knowledge of the guidelines, strongly influence the prescription of radiographs of the ribs in minor chest trauma. KEY POINTS: • Most prescriptors order radiographs of the ribs in minor chest trauma. • Only few prescriptors are aware of referral guidelines. • Information on guidelines does not change their need for radiographs. • Motivations for ordering radiographs are rather legal than medical, but poor compliance to guidelines could also be explained by their unsharpness. • Radiation dose of rib radiographs was 38 times that of a PA chest radiograph.
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