Development of a plain radiograph requesting algorithm for patients presenting with acute abdominal pain

Area of Science:

• Radiology
• Medical Imaging
• Gastroenterology

Background:

• Plain radiograph imaging for acute abdominal pain is frequently questioned by radiologists.
• Concerns exist regarding the appropriateness of requests and the potential for CT scans as a first-line investigation.

Purpose of the Study:

• To audit plain radiograph imaging requests for acute abdominal pain in emergency admissions.
• To develop an algorithm to improve imaging request appropriateness and expedite CT scans.
• To evaluate the utility of broadening plain radiograph interpretation guidelines.

Main Methods:

• Audit of plain radiograph requests against Royal College of Radiologists (RCR) guidelines.
• Analysis of subsequent CT scan utilization within 48 hours.
• Development and proposed implementation of a plain radiograph algorithm.

Main Results:

• Only 80% of plain radiograph requests met RCR guidelines.
• 33% of patients undergoing plain radiography proceeded to CT within 48 hours.
• An algorithm was developed to guide appropriate CT use and improve request quality.

Conclusions:

• Plain radiograph imaging for acute abdominal pain has suboptimal adherence to guidelines.
• An algorithm can enhance the appropriate use of CT scans.
• Broadening interpretation guidelines for plain abdominal radiographs may reduce further imaging and surgery.