Practice patterns in ordering a voiding cystourethrogram for pediatric patients among different specialties in a
Mohammad Hout1, Bilal Aoun2, Lamya Ann Atweh3
1Division of Urology, American University of Beirut-Medical Center, Beirut, Lebanon.
Urology Annals
|May 2, 2019
Summary
Voiding cystourethrogram (VCUG) overuse is common, particularly by general pediatricians, with up to 50% of tests potentially unnecessary. Pediatric urology appropriately utilizes VCUG, highlighting a need for improved referral practices.
Area of Science:
- Pediatric Radiology
- Urology
- Medical Imaging
Background:
- Voiding cystourethrogram (VCUG) is a common diagnostic tool for genitourinary anomalies.
- Overutilization of VCUG can lead to patient discomfort, radiation exposure, and increased healthcare costs.
- Understanding ordering patterns is crucial for optimizing its use.
Purpose of the Study:
- To investigate the practice patterns of ordering voiding cystourethrogram (VCUG) in a Middle Eastern tertiary care center.
- To assess the appropriateness of VCUG indications across different medical specialties.
- To identify potential areas for improving VCUG utilization.
Main Methods:
- Retrospective analysis of 92 pediatric VCUGs over 3 years.
- Extraction of clinical details and ordering physician specialty from electronic health records.
- Evaluation of indications against established guidelines (AAP, NICE, ACR).
Main Results:
- General pediatricians ordered the most VCUGs (50/92).
- Appropriate indication rates varied significantly by specialty, with pediatric urology at 100% and general pediatrics at 50%.
- Adult specialties were noted to order pediatric VCUGs.
Conclusions:
- VCUG utilization patterns differ significantly among specialties.
- General pediatricians exhibit a higher tendency for VCUG misuse.
- Enhanced awareness of indications and improved referral pathways can optimize VCUG use.
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