Do family physicians request ultrasound scans appropriately?

Area of Science:

• Radiology
• Family Medicine
• Medical Imaging

Background:

• Family physicians frequently request diagnostic imaging.
• Ultrasound (US) is a common imaging modality used for various conditions.
• Ensuring appropriate test ordering is crucial for healthcare efficiency and patient care.

Purpose of the Study:

• To evaluate the appropriateness of family physician requests for specific ultrasound scans.
• To determine if the rate of non-clearly indicated ultrasound requests met or exceeded 5% for abdominal, thyroid, pelvic, soft tissue, and carotid examinations.
• To identify trends and reasons for potentially inappropriate ultrasound test ordering.

Main Methods:

• A retrospective analysis of 620 randomly selected ultrasound scan requests was conducted.
• Requests were reviewed by radiologists and family physicians using the Canadian Association of Radiologists' 2005 guidelines.
• Requests were categorized as 'indicated,' 'not clearly indicated,' or 'not legible.'

Main Results:

• Over 5% of requests for abdominal (12.1%), thyroid (18.8%), and carotid (25.2%) ultrasounds were not clearly indicated.
• Pelvic and soft tissue ultrasound requests did not show a significant percentage of unclear indications.
• Common reasons for inappropriate requests included wrong tests, vague clinical questions, and unfocused examinations.

Conclusions:

• A significant proportion of abdominal, thyroid, and carotid ultrasound requests from family physicians lacked clear indications.
• The findings underscore the necessity for enhanced clinical guidelines and educational interventions for managing common patient complaints in primary care.
• Improving the clarity and justification of imaging requests can optimize resource utilization and diagnostic accuracy.