在急诊室中,不适当的部CT扫描请求增加了过度使用,并降低了测试性能
Juana María Plasencia-Martínez1, Marta Sánchez-Canales2, Elena Otón-González2
1Department of Radiology, Hospital General Universitario Morales Meseguer, Avenida Marqués de los Vélez, s/n, 30008, Murcia, Spain. Plasen79@gmail.com.
Emergency radiology
|November 16, 2023
概括
对于非创伤性部CT扫描的电子请求和出院摘要之间的差异很常见,导致不必要的测试. 改善临床证明对于管理扫描超载至关重要.
科学领域:
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
- 医疗信息学 医疗信息学
背景情况:
- 越来越多地使用非创伤性紧急头骨计算机断层扫描 (NT-UCCT) 扫描.
- 对于这些扫描的临床理由的质量存在有限的研究.
- 了解临床信息中的差异对于优化资源配置至关重要.
研究的目的:
- 评估电子NT-UCCT请求中的临床信息与急诊部出院摘要之间的一致性.
- 分析这些差异对NT-UCCT过载的影响.
- 识别导致不准确请求的特定迹象和症状.
主要方法:
- 在2017-2021年间对156名接受NT-UCCT的患者进行了回顾性研究.
- 电子请求中的迹象/症状与排放摘要的比较.
- 对CT发现,最终诊断和一致率的分析.
主要成果:
- 只有23.1%的患者在请求和摘要之间完全同意.
- 运动缺陷是频繁的错误阳性,急性CT发现的预测值较低.
- 恶心/吐是常见的假阴性,降低了相关CT发现的可能性.
- 不一致性在非神经疾病中更为普遍.
结论:
- 超过75%的NT-UCCT请求显示电子信息和放电总结之间存在差异.
- 这些差异导致不必要的NT-UCCT测试和潜在的过载.
- 提高电子请求中临床理由的准确性至关重要.
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