Clinico-radiological meetings: Are they worthwhile?

doi:10.1016/S0009-9260(05)80171-0

Clinical Radiology

Volume 46, Issue 4, October 1992, Pages 279-280

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The proceedings of 22 clinico-radiological meetings were analysed in order to assess some aspects of their benefits and cost.

The mean duration of each meeting was 30.4 min. On average, the clinical and radiological details of eight patients were discussed at each meeting. The mean number of changes in the leading diagnosis was 1.6 per meeting, and a mean of 1.9 management decisions were made. A mean of 1.6 further radiological tests were recommended, offset by a mean of 0.7 scheduled investigations which were deemed no longer necessary. The cost of the salaries of the staff attending each meeting amounted to £73.82. Thus the cost of a revised leading diagnosis was calculated at £46.14 whilst that of a management decision came to £38.85. The assumed educational benefits of these meetings and inevitable lost opportunity costs were not analysed.

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Cited by (21)

Outsourcing and Teleradiology: Potential Benefits, Risks and Solutions From a UK/European Perspective
2008, Journal of the American College of Radiology
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Analysis of radiological examination request forms in conjunction with justification of X-ray exposures
2005, European Journal of Radiology
Objectives: To evaluate the adequacy of patient data and clinical information transmitted to the radiological departments by the referring clinicians in view of the justification demands concerning the radiological examinations, as those are described in the Radiation Protection Regulations of the European Union Nations. Materials and methods: Request forms for 1708 patients referred to radiology department and 410 referred to the CT department were evaluated concerning the proper completion of the form fields. Furthermore, for CT examinations a more detailed evaluation was carried out, to assess the rationalistic use of CT within the diagnostic algorithm. Results: Not properly completed request forms to both departments were observed, however, the omissions were more prominent for the referrals to the radiology department, where the age and the probable clinical diagnosis was not given in 81.5 and 46% of the forms, respectively. Furthermore, the emergency indication was less cautiously used compared to the CT requests. For the CT department 33.3% of requests were justified and the final diagnosis was included in the referring doctor’s probable clinical diagnosis. U/S was the examination of choice in 51% of the cases where an examination should have been performed before CT and in 70.6% of the cases where an alternative examination was proposed. Conclusions: The inadequate transmission of clinical information and the large number of not fully justified CT requests observed in this study are typical examples of the various problems that radiologists have to face in order to apply the justification directives.
Relationships between radiologists and clinicians: Results from three surveys
2000, Clinical Radiology
AIM: To analyse reasons for and the nature of clinico-radiological contacts and their clinical impact.
MATERIALS AND METHODS: Three different surveys were performed. (1) Data concerning contacts between staff radiologists (n = 20) and clinicians during 10 consecutive working days were collected; (2) staff clinicians (n = 174) filled in a questionnaire asking for their opinions about relationships with radiologists; (3) staff radiologists collected data about contacts with clinicians related to more urgent/complicated cases. Radiologists assessed the clinical impact of the radiological procedure and of the consultation.
RESULTS: (1) During 220 working days 20 radiologists had a mean of 3.95 contacts per day (48.2% personal contacts, 51.8% telephone contacts), amounting to a personal total of 21.65 min per day. These contacts amounted to a total of 7.08 h per day, roughly one whole-time equivalent radiologist. (2) These consultations helped to refine the diagnostic strategy often (12.6%) or sometimes (71.4%) and to alter therapeutic decisions often (10.4%) or sometimes (56.6%). (3) The initial clinical diagnosis was changed in 50% of cases and the therapy was substantially changed on the basis of further radiological investigations and clinical–radiological discussion in 60% of cases.
CONCLUSION: Clinical–radiological consultations are time consuming but have a beneficial diagnostic and therapeutic impact.Dalla Palma, L. (2000). Clinical Radiology55, 602–605.
Evidence-based diagnostic radiology
1997, Lancet
The radiological community has a long track record of self-examination, starting well before evidence-based medicine came of age. It had to produce such evidence to prove the need for and win funds for its expensive gadgets. The assessment of new tests is easier than proving the value of well-established ones, and in scrutinising the evidence base for an imaging technique a balance must be struck between apparent (eg, diagnostic) benefit and real benefit to the patient. And even when there is a wealth of good evidence healthy debate continues. So radiology may be ahead of some other disciplines in considering the evidence for its daily practice. For example, where is the evidence for the routine clinical examination—and might the radiologist with a chest X-ray and abdominal ultrasound do better?
Radiologists working with clinicians to improve the request process for radiological tests did not reduce the number of tests ordered
1997, Evidence-based Healthcare
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Original PaperClinico-radiological meetings: Are they worthwhile?

Audit — how we carry it out

Clinical Radiology

Original Paper
Clinico-radiological meetings: Are they worthwhile?