Ordering of renal tract imaging by paediatricians after urinary tract infection.
OBJECTIVE
To describe paediatricians' reported ordering of renal tract imaging of children following urinary tract infection.


METHODS
This is a piloted self-administered survey. A total of 354 randomly sampled practising paediatricians in Australia participated in the survey. The survey included 12 clinical scenarios that varied with age, gender and fever. Respondents indicated their likelihood of ordering renal ultrasound, micturating cystourethrogram (MCU) and dimercaptosuccinic acid scan (DMSA) from 0 to 100%.


RESULTS
Response rate was 74.6% (264/354). For all clinical scenarios the median probability of ordering an ultrasound was 100% with little variability. For children aged 2 months, likelihood of ordering an MCU was 100%, with little variability, but was 70% for 3-year-olds with fever (45% without fever), and 5% for 6-year-olds with very large variability. Median likelihood of ordering a DMSA was 80% at 2 months, 60% at 3 years and 20% at 6 years (40%, 15%, 5% without fever, respectively). Variability was large for all scenarios and DMSA ordering. Child gender did not influence ordering practices.


CONCLUSIONS
Renal tract imaging practice across paediatricians shows consistent, approximately 100% use of the least invasive modality, ultrasound. In contrast, there is considerable variation in the reported ordering of the more invasive tests MCU and DMSA. Doctors order these tests more in younger children and when fever is present.
Williams
Gabrielle
G
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, and Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, New South Wales, Australia. gabriew4@chw.edu.au
Sureshkumar
Premala
P
Chan
Siew F
SF
Macaskill
Petra
P
Craig
Jonathan C
JC
D001315:Australia; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D010372:Pediatrics; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D014552:Urinary Tract Infections