NECESSITY OF REQUESTED RADIOLOGICAL EXAMI NATIONS - A PROSPECTIVE-STUDY

Purpose: What is the percentage of non-indicated examinations in the r outine work of a radiologic university clinic? Methods: From April 1 s t, 1994, to June 30th, 1994, all examinations carried out in the Radio logy Department of the University Hospital of Cologne, Germany, were e valuated prospectively by the radiological medical staff using a quest ionnaire. The question was whether the examinations were medically ind icated or not. Requests for examinations which were not carried out du e to tacking indications were excluded from evaluation. The percentage of error was assessed by analysis of random samples assigned to the r eferring clinicians. Results: 1400 (5.4%) of a total of 25718 examinat ions were considered by the radiological medical staff as ''not indica ted''. A subsample analysis performed for validation gave an upper mar gin of a 95% confidence interval of about 13% for this rating. The per entage of non-indicated examinations was higher in conventional x-ray examinations and ultrasonography than in x-ray angiography, computed t omography and magnetic resonance tomography. Examinations during night time and weekend showed a higher percentage of lacking medical indica tions than examinations during daytime. Conclusions: Considering a uni versity clinic concerned with educational work, the percentage of radi ological examinations carried out without medical indication was toler able. However, indications must be further improved by intensifying th e communication with the referring clinicians and by elaborating a hig her standard of radiological and clinical postgraduate training.