Indications for pelvic sonography-Do patients and doctors agree?
OBJECTIVE
Often, it seems that the patient history provided by the referring clinician on the sonography requisition form differs from that given by the patient during the sonographic examination. Because such a discrepancy in the history may delay the scan and disrupt the daily work flow while the referring clinician is contacted for clarification, we sought to document the incidence and cause of such discrepancies at our institution.


METHODS
During a 3-month period, all outpatients who were referred for a pelvic sonographic examination were asked to indicate their understanding of why the examination had been requested. The health care providers' reasons for requesting sonography were recorded using a computer order entry system. Each pair of responses (health care provider and patient) were classified as either concordant or discordant. Patient and physician characteristics were fit into a logistic regression model with concordance of history as the outcome variable.


RESULTS
One hundred fifty-six (90%) of the 173 patients enrolled in our study indicated that their health care provider had discussed with them the reason for ordering the sonographic examination. The histories provided by the patient and health care provider were concordant in 134 (77%) of 173 cases. The histories provided by the patient and health care provider were more likely to be concordant if the patient's insurance was a managed care plan or if the patient had a college or graduate level education, had been cared for by the same health care provider for more than 2 years, or had been seen by a female health care provider. Concordance of history was not associated with a higher incidence of abnormal sonographic findings.


CONCLUSIONS
It appears that health care providers, despite increased demands on their time, adequately discuss with their patients the reasons for ordering a pelvic sonographic examination. However, our study suggests that health care providers may need to spend additional time with patients whose education is limited and that male physicians may need to pay particular attention to their communication with female patients.
Rosen
M P
MP
Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts 02215, USA.
Mehta
T
T
Levine
D
D
Davis
R B
RB
D000328:Adult; D003142:Communication; D004522:Educational Status; D004717:Endometrium / Q000000981:diagnostic imaging; D005260:Female; D005831:Genital Diseases, Female / Q000000981:diagnostic imaging*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D008487:Medical History Taking / Q000592:standards*; D009215:Myometrium / Q000000981:diagnostic imaging; D016017:Odds Ratio; D010053:Ovary / Q000000981:diagnostic imaging; D010388:Pelvis / Q000000981:diagnostic imaging; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D014481:United States; D016387:Women's Health