ArticleEuropean radiology2023
Did medical doctors who order abdominal CT scans during on-call hours truly become worse at clinical reasoning? Yes, they did.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 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
5 citing papers in PubMed, 9 citations in OpenAlex.
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- Review
- Can radiology requisition quality reflect clinical reasoning? Insights from a RI-RADS evaluation of emergency CT referrals.Insights into imaging · 2025Article
- German surgeons' perspective on the application of artificial intelligence in clinical decision-making.International journal of computer assisted radiology and surgery · 2025Article
- Turning radiology reports into epidemiological data to track seasonal pulmonary infections and the COVID-19 pandemic.European radiology · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate temporal changes in clinical reasoning quality of physicians who requested abdominal CT scans at a tertiary care center during on-call hours within a 15-year period.
methodsThis retrospective study included 531 patients who underwent abdominal CT at a tertiary care center during on-call hours on 36 randomly sampled unique calendar days in each of the years between 2005 and 2019. Clinical reasoning quality was expressed as a percentage (0-100%), taking into account the degree by which the differential diagnoses on the CT request form matched the CT diagnosis. Temporal changes in the quality of clinical reasoning and number of CT scans were assessed using Mann-Kendall tests. Associations between the quality of clinical reasoning with patient age and gender, requesting department, and time of CT scanning were determined with linear regression analyses.
resultsThe median annual clinical reasoning score was 0.4% (interquartile range: 0.3 to 0.6%; range: 0.1 to 1.9%). The quality of clinical reasoning significantly decreased between 2005 and 2019 (Mann-Kendall Tau of -0.829, p < 0.001), while the number of abdominal CT scans significantly increased (Mann-Kendall tau of 0.790, p < 0.001). There was a significant association between the quality of clinical reasoning and patient age (β coefficient of 0.210, p = 0.002). The quality of clinical reasoning was not significantly associated with patient gender, requesting department, or time of CT scanning.
conclusionThe clinical reasoning quality of physicians who request abdominal CT scans during on-call hours has deteriorated over time. Clinical reasoning appears to be worse in younger patients. KEY POINTS: • In patients with suspected acute abdominal pathology who are scheduled to undergo CT scanning, referring physicians generally have difficulties in making an accurate pretest (differential) diagnosis. • Clinical reasoning quality of physicians who request acute abdominal CT scans has deteriorated over the years, while the number of CT scans has shown a significant increase. • Clinical reasoning quality appears to be worse in younger patients in this setting.
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