Imaging of patients with clinically suspected appendicitis in the Netherlands: conclusions of a survey.
The aim of this study was to summarize the extent of variation in imaging strategies in patients clinically suspected of having appendicitis. By means of a written survey, the policies for the imaging management of patients clinically suspected of having appendicitis in the Netherlands were inventoried. A questionnaire was sent to the departments of surgery and radiology of all 105 Dutch hospitals, including the 8 academic medical centres, in March 2006. Questionnaires were returned from 98 hospitals. It was found that, in the work-up of patients suspected of having appendicitis, ultrasound or CT was performed in a minority of hospitals for 50% or more of these patients. In the majority of hospitals, it was carried out for less than 50% of these patients. There is a widespread variability in pre-operative imaging regardless of hospital type. This survey shows that, despite the ubiquitous presence of ultrasound and CT in Dutch hospitals, the pre-operative imaging work-up in patients clinically suspected of having acute appendicitis does not reflect this, being performed in only a minority of patients suspected of having acute appendicitis. Radiologists and surgeons alike should be aware of the positive impact of adjunctive imaging in this group of patients - most importantly lowering the negative appendicectomy rate and also lowering total hospital costs.
Cobben
L P
LP
Department of Radiology, Medisch Centrum Haaglanden, Lijnbaan 32, 2501 CK Den Haag, The Netherlands. coblod@tiscali.nl
Bakker
O J
OJ
Puylaert
J B
JB
Kingma
L M
LM
Blickman
J G
JG
D000704:Analysis of Variance; D001064:Appendicitis / Q000175:diagnosis* / Q000191:economics; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics; D008297:Male; D009426:Netherlands; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000191:economics