ArticleEuropean radiology2021
Are referral guidelines for CT examinations addressing all clinical scenarios? A comparison of EURO-2000 Guidelines and ESR iGuide.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Impact and effect of imaging referral guidelines on patients and radiology services: a systematic review.European radiology · 2025Pooled it
- Comparison of CT referral justification using clinical decision support and large language models in a large European cohort.European radiology · 2025Article
- Computed tomography referral guidelines adherence in Europe: insights from a seven-country audit.European radiology · 2025Article
- Evaluating the reliability of ChatGPT as a tool for imaging test referral: a comparative study with a clinical decision support system.European radiology · 2024Article
- Clinical decision support system recommendations: how often do radiologists and clinicians accept them?European radiology · 2022Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate the proportion of clinical scenarios covered by EURO-2000 Guidelines and ESR iGuide, and assess compliance with both guidelines.
methodsThe clinical indication on archived request forms for head, chest, abdomen-pelvis, and spine CT examinations performed in three hospitals in January 2018 was retrospectively matched with EURO-2000 Guidelines and ESR iGuide. For clinical scenarios addressed in the guidelines, the compliance with the guidelines was assessed. Analysis was performed on pooled data from the three centres and further stratified by centre, body region, and prescriber's specialisation. The differences in categorical data distributions between centres, body regions, and prescribers' specialisations were assessed with paired McNemar's χ
resultsA total of 6,812 requests for 7,217 CT examinations were analysed. Sixty-five percent of clinical situations that lead to prescribing CT examinations were addressed in EURO-2000 Guidelines compared with 81% for ESR iGuide. Proportions of clinical scenarios covered by the guidelines were statistically different between centres and body regions (p < 0.001) and varied according to prescribers' specialisations (p ranging from < 0.001 to 0.531). Both EURO-2000 Guidelines and ESR iGuide encompassed more clinical scenarios in certain body regions, favouring, e.g. spine and head over abdomen and chest. The proportion of "unjustified examinations" was greater according to EURO-2000 Guidelines (46%) than ESR iGuide (23%) (p < 0.001).
conclusionsBoth EURO-2000 Guidelines and ESR iGuide do not address numerous common clinical scenarios. The proportions of scenarios addressed differ according to the centre, body region, and prescribers' specialisation. Any estimation of compliance with referral guidelines is therefore of relative significance. KEY POINTS: • ESR iGuide performs better than earlier EURO-2000 Guidelines for the coverage of all possible clinical scenarios leading to CT referrals. • Differences in coverage of clinical scenarios by both referral guidelines are observed for different body regions and/or prescribers' subspecialties. • As referral guidelines are incomplete, any estimation of justified or unjustified CT requests is of relative significance.
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