Related Experiment Videos
Is aortography abused in lower-limb iscaemia?
Insights
Aortography requests were reviewed, with 51% deemed inappropriate or of marginal value, highlighting the need for experienced staff to request this diagnostic imaging only when operative treatment is planned.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Health Services Research
Background:
- Aortography is a key diagnostic tool in vascular surgery.
- Assessing the appropriateness of aortography requests is crucial for efficient healthcare resource allocation.
- Previous studies have indicated variability in the utilization of diagnostic imaging procedures.
Purpose of the Study:
- To evaluate the justification and impact of aortography requests on patient management.
- To identify factors contributing to inappropriate or marginally valuable aortography requests.
- To propose guidelines for optimizing aortography utilization.
Main Methods:
- Retrospective review of 82 aortography requests from 1978 at a single hospital.
- Analysis of patient records to determine the justification for each aortography request.
- Categorization of requests into fully justified, inappropriate, or of marginal value.
Main Results:
- 49% of aortography requests were fully justified.
- 51% of requests were considered inappropriate (38%) or of marginal value (13%).
- No patients with unjustified aortograms underwent reconstructive surgery; reasons linked to clinical specialty and physician experience.
Conclusions:
- A significant proportion of aortograms were requested inappropriately or offered marginal value.
- Experienced medical staff should request aortography, exclusively when operative treatment is decided.
- A suggested algorithm can aid in judiciously deciding when to perform an aortogram.
Abstract:
Request for aortography on 82 patients in one hospital in 1978 were assessed to determine the effect of the investigation on the patient's subsequent management. In 49% of cases the request was fully justified. In the remaining 51% of patients, none of whom had reconstructive surgery, the request was considered either inappropriate (38%) or of marginal value (13%). The reasons for this high porportion of unnecessary aortograms were related to the clinical specialty and the level of experience of the doctor making the request. A simple algorithm which may be helpful when deciding to perform an aortogram is suggested. It is concluded that aortography should be requested only by experienced medical staff and only after a decision has been taken to offer the patient operative treatment.