Critical issues in radiology requests and reports.
OBJECTIVE
This study evaluated the appropriateness and accuracy of 500 radiology requests and their matched reports in order to identify recurring errors in both areas.


METHODS
A randomly chosen sample consisting of 167 computed tomography (CT), 166 ultrasonography (US) and 167 radiographic examinations were collected and analysed according to national referral guidelines and to the principles of justification and optimisation (Law no. 187/2000).


RESULTS
We identified a high rate of inappropriate requests (27.6%) and requests lacking a clinical question (22%). There was good precision in the anamnestic data (80.6%) and in the formulation of the diagnostic question (76.8%). Almost all requests were handwritten, and 12.5% lacked the referring physician's stamp and/or signature. No report mentioned the clinical information received or the equipment used. The use of contrast medium was always reported. Conclusions were reported in 9.8% of these reports. When further investigation would have been necessary, the radiologist omitted to report this in 60% of cases.


CONCLUSIONS
Some important weaknesses emerged, especially regarding requests for radiological examinations (22% lacked the clinical question, 27.6% were inappropriate), potentially limiting the effectiveness of the diagnostic process and leading to negative effects on the correct risk management process. There emerges a need for better collaboration between clinicians and radiologists.
De Filippo
M
M
Sezione di Scienze Radiologiche, Dipartimento di Scienze Cliniche, Università degli Studi di Parma, Ospedale Maggiore di Parma, Via Gramsci 14, 43100, Parma, Italy. massimo.defilippo@unipr.it
Corsi
A
A
Evaristi
L
L
Bertoldi
C
C
Sverzellati
N
N
Averna
R
R
Crotti
P
P
Bini
G
G
Tamburrini
O
O
Zompatori
M
M
Rossi
C
C
D003287:Contrast Media; D006801:Humans; D007558:Italy; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014463:Ultrasonography / Q000706:statistics & numerical data*
D003287:Contrast Media