title: Clinically Unjustified Diagnostic Imaging - a Worrisome Tendency in Today's Medical Practice.
abstract: BACKGROUND
  The purpose of the study was to evaluate the percentage of unjustified examinations among all the CT and MRI studies performed by two radiology departments and to determine the types of examinations which are most commonly carried out unnecessarily.
  
  
  METHODS
  Three radiologists assessed the justification of CT and MRI examinations performed during a period of 14 days based on the referrals. The radiologists assessed 799 referrals for CT scans (847 examinations of a particular part of the body) and 269 MRI referrals (269 examinations). The criteria for justification were: medical expertise and the guidelines. During the first stage radiologists divided the examinations into 3 groups: justified, unjustified and the examinations of questionable justification. The second step was to determine the reasons why the studies were considered as unjustified or of questionable justification.
  
  
  RESULTS
  73 of 1116 examinations (6.54%) were considered to be unjustified or of a questionable justification. There were 59 CT scans (59/847=6.97%) and 14 MRI studies (14/269=5.20%). The most common reasons to consider them as unjustified or of questionable justification were: inadequate method of diagnostic imaging chosen as a first-line tool and lacking or insufficient clinical details.
  
  
  CONCLUSIONS
  In our investigation 6.54% of both CT and MRI examinations were considered as unjustified or of questionable justification, which is lower than described in other studies (from 7% to 26%). The assessment was based only on referrals, therefore a total share of these examinations is likely to be higher.
authors.affiliation: Department of Diagnostic Radiology, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sobiecka
authors.affiliation: Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Bekiesińska-Figatowska
authors.affiliation: Warsaw School of Economics, Collegium of Socio-Economics, Warsaw, Poland.
authors.forename: Milena
authors.initials: M
authors.lastname: Rutkowska
authors.affiliation: Department of Radiology and Diagnostic Imaging, Medical Centre for Postgraduate Education, Professor Adam Gruca's Clinical Hospital, Otwock, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Latos
authors.affiliation: Department of Diagnostic Radiology, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland; Department of Radiology and Diagnostic Imaging, Medical Centre for Postgraduate Education, Professor Adam Gruca's Clinical Hospital, Otwock, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Walecki
keywords: Magnetic Resonance Imaging; Referral and Consultation; Tomography, Spiral Computed