Justification of Imaging Referrals: A Cross-Sectional Survey of Referring Physicians' Knowledge, Practices, and...

This study aimed to evaluate referral physician' confidence, practices, and barriers in justifying imaging referrals, with specific focus on the impact of training, workload, and guideline accessibility on referral appropriateness.

A cross-sectional survey was conducted among 167 referral physicians across various hospitals in the United Arab Emirates. A validated, self-administered questionnaire captured demographic data, referral practices, confidence levels, guideline usage, training participation, and perceived barriers to appropriate imaging justification. Data were analyzed using descriptive statistics and inferential tests, including chi-square, Mann-Whitney U, and Kruskal-Wallis tests.

Although 82% of physicians reported high confidence in assessing imaging necessity, over 60% acknowledged frequent issues with referral quality. More than half (51.5%) admitted that imaging referrals were sometimes unnecessary. Training participation was significantly associated with better guideline accessibility (chi-square=50.50, p<0.001), and a small but significant association was found between confidence and experience (U=1,903, p=0.038). Key improvement strategies included enhanced physician-radiologist communication, increased training, and better guideline access.

Despite high self-reported confidence, systemic and educational gaps persist in imaging referral justification. Addressing training needs and improving access to guidelines can enhance appropriateness in clinical imaging decisions.