1998 ARRS Executive Council Award. Radiology in the emergency department: technique for quantitative description of use and results. American Roentgen Ray Society.
OBJECTIVE
We sought to develop quantitative methods to describe the use and results of imaging studies in emergency department patients.


METHODS
A computerized nonrelational database containing records of 3.5 million diagnostic reports generated by our radiology department from 1988 to 1997 was queried using Boolean and natural language search tools. Each record contained data fields for patient demographics, examination description and billing code, names of interpreting radiologists and referring physicians, patient history, report body, and report impression.


RESULTS
Emergency department admissions and imaging studies were stable from 1991 to 1997, averaging 60,000 and 52,000 per year, respectively. Bone radiographs comprised 45.1% of examinations; chest radiographs, 44.6%; and abdominal radiographs, 10.4%. The percentages of radiographs interpreted as normal were 75.9% in 1992 and 75.3% in 1996, with cervical spine (88.7%), thoracic spine (86.3%), and knee (86.3%) yielding the highest proportion of studies with normal findings. The number of CT studies of the body increased from 1840 in 1993 to 3101 in 1997. Studies of the abdomen accounted for most of this increase (52.3% in 1993 to 66.0% in 1997). During evaluations for cervical spine injury, a mean of 6.5% of radiographic studies were followed by CT studies, and the findings of 89.0% of those CT studies were interpreted as normal.


CONCLUSIONS
Radiology report databases represent a resource from which broad descriptions of the use and results of imaging studies can be obtained. Such descriptions may be useful in departmental and hospital administration, technology assessment, cost-effectiveness studies, and health policy formulation.
Lee
S I
SI
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston 02114-2968, USA.
Chew
F S
FS
D000465:Algorithms; D001363:Awards and Prizes; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011859:Radiography / Q000706:statistics & numerical data*; D011871:Radiology; D011873:Radiology Information Systems / Q000706:statistics & numerical data; D012955:Societies, Medical; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014193:Trauma Centers / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review / Q000379:methods / Q000706:statistics & numerical data