ArticlePloS one2018
Impact of clinical history on choice of abdominal/pelvic CT protocol in the Emergency Department.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 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
4 citing papers in PubMed.
- Can radiology requisition quality reflect clinical reasoning? Insights from a RI-RADS evaluation of emergency CT referrals.Insights into imaging · 2025Article
- Radiographers' actions and challenges when confronted with inappropriate radiology referrals.European radiology · 2022Article
- The Accuracy of On-Call CT Reporting in Teleradiology Networks in Comparison to In-House Reporting.Healthcare (Basel, Switzerland) · 2021Article
- Hypovascular pancreas head adenocarcinoma: CT texture analysis for assessment of resection margin status and high-risk features.European radiology · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRadiologists and other specialty consultants play a role in diagnosing patients with acute abdominal conditions. Numerous Computed Tomography (CT) protocols are available and radiologists' choices are influenced by the clinical history provided. We hypothesize that the quality of the initial communication between referring physicians and radiologists greatly affects the utilization of health resources and subsequent patient care. The purpose of this pilot study was to employ a grading system to quantitatively evaluate a provided history. We also sought to evaluate inter-rater reliability by having radiologists evaluate sample histories and finally, to assess whether the quality of history has an impact on the number of CT protocols radiologists choose as potentially appropriate, with less potential protocols being seen as a positive outcome.
methodsFour reviewers, (2 attendings and 2 residents) evaluated 350 consecutive clinical histories provided for patients presenting to a tertiary care Emergency Department (ED) between September-October, 2012. Reviewers graded histories on a 5-point scale using 4 categories of criteria. This includes a) presenting complaint, b) relevant past medical history or symptom evolution, c) objective laboratory or prior examination results and d) differential diagnosis.
resultsThere was substantial agreement among all four reviewers when evaluating the quality of history, ICC 0.61, (95% CI 0.48-0.71). In particular, agreement amongst attending radiologists was substantial, with ICC 0.69 (0.48-0.80). Significant negative correlation was observed between history grade and number of potentially appropriate protocols in 3 of 4 reviewers (Spearman's rho: -0.394, -0.639, -0.864, p <0.0001 for these reviewers). This correlation was significantly stronger for attending radiologists (Spearman's rho: -0.763, 95% CI -0.7933 to -0.731; p<0.0001). Agreement was poor among reviewers when asked exactly how many protocols could potentially be used to answer the clinical question based on provided history, ICC 0.08, (95% -0.03-0.13).
conclusionAlthough there is still variability in radiologists' approach to protocoling urgent studies, a more comprehensive requisition history narrowed the number of protocols considered.
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