Clinical Evaluation Before MRI Referral: Frequency and Association with Diagnostic Yield

Area of Science:

• Radiology
• Clinical Practice
• Medical Diagnostics

Background:

• Thorough patient history and physical examination are foundational in medical diagnostics.
• The increasing reliance on advanced imaging like MRI necessitates evaluating the completeness of pre-referral clinical assessments.

Purpose of the Study:

• To quantify the frequency of omitted history taking and physical examinations prior to MRI referrals.
• To investigate the association between these omissions and the quality of clinical reasoning and the diagnostic yield of MRI.

Main Methods:

• A prospective study surveyed 275 adult patients undergoing MRI.
• Assessed omission of history and physical exams before MRI referral.
• Used multivariable regression to analyze associations with clinical reasoning quality and MRI positivity.

Main Results:

• History taking was omitted in 18.2% and physical examination in 70.9% of cases.
• Omissions varied based on visit type and requesting clinician.
• No significant association was found between omitted assessments and clinical reasoning quality or MRI positivity.

Conclusions:

• History taking and physical examination are often omitted before MRI referral.
• While not statistically linked to reasoning quality or diagnostic yield in this cohort, reduced bedside assessment may diminish clinical context for MRI referrals and interpretation.