Use of thoracic computed tomography by general practitioners

Area of Science:

• Radiology
• Medical Imaging
• Diagnostic Procedures

Background:

• Computed tomography (CT) scans are frequently requested by general practitioners (GPs) for chest examinations.
• The appropriateness and clinical utility of these GP-requested CT scans require evaluation to optimize patient care and resource allocation.

Purpose of the Study:

• To audit general practitioner requests for chest CT examinations.
• To assess the appropriateness and usefulness of these CT investigations in a regional Australian center.

Main Methods:

• A review of 50 consecutive chest CT requests from two private radiology practices was conducted.
• Clinical details were abstracted, and the appropriateness of each CT scan for its specified indication was subjectively assessed.

Main Results:

• Only 32% of chest CT scans were deemed appropriate, with 68% considered inappropriate.
• Inappropriate CT scans often did not resolve the GP's clinical problem, and sometimes the wrong type of CT scan was performed.
• Many patients with recent normal chest X-rays also had normal CT scans, suggesting overuse of CT.

Conclusions:

• A significant proportion of chest CT scans requested by GPs are unnecessary and could be replaced by simpler, less costly, and lower-radiation diagnostic methods.
• Unnecessary CT scans contribute to radiation exposure, potentially leading to fatal cancers, highlighting the need for improved referral guidelines.