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Excretory urography in current practice: evidence against overutilization.

P Doubilet, B J McNeil, F X Van Houten

    Radiology
    |March 1, 1985
    PubMed
    Summary
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    Predictive models for excretory urography (EU) did not improve patient selection. Current clinical criteria effectively identify patients needing EU, suggesting current utilization frequency is appropriate.

    Area of Science:

    • Urology
    • Diagnostic Imaging
    • Medical Informatics

    Background:

    • Excretory urography (EU) is a common diagnostic tool for genitourinary conditions.
    • Reducing unnecessary EU procedures could improve efficiency and reduce patient exposure.

    Purpose of the Study:

    • To determine if genitourinary signs and symptoms can predict normality or specific diseases, thus optimizing EU use.
    • To develop and validate predictive algorithms for patient selection for EU.

    Main Methods:

    • A prospective study involving over 3,000 patients across three healthcare settings.
    • Application of a polychotomous logistic regression model to identify predictive combinations of symptoms and signs.

    Main Results:

    Related Experiment Videos

  • The developed predictive algorithms performed poorly in differentiating normal from abnormal patients.
  • The logistic model required testing 90% of patients to detect 95% of abnormal urograms, indicating low predictive value.

    • Conclusions:

    • Current clinical selection criteria for excretory urography are effective.
    • The existing frequency of EU utilization is deemed appropriate based on study findings.