Evaluation of plain abdominal radiography prescriptions in a University Hospital Center

OBJECTIVES: the aim of this study was to evaluate the prescription, impact and diagnostic utility of plain abdominal radiography in a University Hospi tal. METHODS: Plain abdominal radiography series performed over 15 consecutive d ays were evaluated for quality and agreement with the patient's clinical st atus. Agreement between the final diagnosis and the radiographic findings w ere also compared. Contribution of plain abdominal radiography to final dia gnosis was assessed on the basis of the conclusions on the hospital dischar ge report or from those drawn from a telephone survey. The same relationshi p was also assessed in terms pf clinician status (medical student, resident physician, senior physician). RESULTS: The series included 175 radiography series (11.6 per day). In 86% of the cases, the choice of Views was adapted to the clinical context In 14 % it was not The quality of the x-rays was found to be unsatisfactory in 17 %, good in 63% and excellent in 20%. The radiography was considered to be c ontributive to the final diagnosis in 13% of the cases and non-contributive in 87%. Clinician status was not correlated with the degree of usefulness for final diagnosis. Finally, the prescription was in agreement with standa rd guidelines in 28% of the cases and not in agreement in 72%. CONCLUSION: Plain abdominal radiographs are neither sensitive nor specific, frequently misleading, and cosily per specific and correct diagnosis. Bett er physician awareness is required to limit the number of unnecessary exami nations.