Recent research has shown that more than half of abdominal CT exams in the U.S. involve an inappropriate imaging exam -- unnecessarily exposing patients to additional radiation, noted presenter Dr. Pamela Johnson from Johns Hopkins Hospital. A likely cause is the lack of formal education regarding appropriate indications for abdominal CT provided to nonradiology clinicians who order the test.
To assess clinicians' understanding of appropriate abdominal CT protocols, Johnson and colleagues created a survey that asked clinicians to choose the type of abdominal CT exam best suited for evaluating 10 distinct clinical scenarios, such as gastrointestinal bleeding and kidney infection. The survey also included questions about the clinicians' knowledge of how abdominal CT is performed and costs associated with the tests.
More than 100 clinicians -- including nurses, residents, and attendings from various specialties -- responded to the survey and chose whether each case warranted a CT exam without contrast, CT with oral and/or intravenous (IV) contrast, or CT without and then with IV contrast.
The average score on the survey was nearly 30% better for the radiologists than it was for the nonradiology clinicians. The difference in score between radiologists and physicians from any other specialty was statistically significant -- as was the difference between radiology residents and nonradiology faculty.
Among nonradiology providers, surgeons had the highest score, followed by emergency physicians and then internal medicine physicians.
As nonradiology medical providers continue to develop their understanding of abdominal CT, radiologists must be responsible for proper protocol selection to maintain safe, high-quality imaging, the study authors noted.
