Indications for pelvic sonography - Do patients and doctors agree?

Purpose. Often, it seems that the patient history provided by the referring clinician on the sonography requisition form differs from that given by th e patient during the sonographic examination. Because such a discrepancy in the history may delay the scan and disrupt the daily work flow while the r eferring clinician is contacted for clarification, we sought to document th e incidence and cause of such discrepancies at our institution. Methods. During a 3-month period, all outpatients who were referred for a p elvic sonographic examination were asked to indicate their understanding of why the examination had been requested. The health care providers' reasons for requesting sonography were recorded using a computer order entry syste m. Each pair of responses (health care provider and patient) were classifie d as either concordant or discordant. Patient and physician characteristics were fit into a logistic regression model with concordance of history as t he outcome variable. Results. One hundred fifty-six (90%) of the 173 patients enrolled in our st udy indicated that their health care provider had discussed with them the r eason for ordering the sonographic examination. The histories provided by t he patient and health care provider were concordant in 134 (77%) of 173 cas es. The histories provided by the patient and health care provider were mor e likely to be concordant if the patient's insurance was a managed care pla n or if the patient had a college or graduate level education, had been car ed for by the same health care provider for more than 2 years, or had been seen by a female health care provider. Concordance of history was not assoc iated with a higher incidence of abnormal sonographic findings. Conclusions. It appears that health care providers, despite increased deman ds on their time, adequately discuss with their patients the reasons for or dering a pelvic sonographic examination. However, our study suggests that h ealth care providers may need to spend additional time with patients whose education is limited and that male physicians may need to pay particular at tention to their communication with female patients. (C) 2000 John Wiley & Sons, Inc.