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Congress: ECR25
Poster Number: C-11295
Type: Poster: EPOS Radiographer (scientific)
Authorblock: Y. X. Tay1, S. J. Foley2, R. P. Killeen2, M. E. Ong1, R. Chen1, L. P. Chan1, E. J. Tan1, W. Hou1, J. Mcnulty2; 1Singapore/SG, 2Dublin/IE
Disclosures:
Yi Xiang Tay: Nothing to disclose
Shane J Foley: Nothing to disclose
Ronan P Killeen: Shareholder: xWave Technologies Ltd
Marcus Eh Ong: Nothing to disclose
Robert Chen: Nothing to disclose
Lai Peng Chan: Nothing to disclose
Eu Jin Tan: Nothing to disclose
Wenlu Hou: Nothing to disclose
Jonathan Mcnulty: Nothing to disclose
Keywords: Musculoskeletal spine, Radiographers, Radioprotection / Radiation dose, Conventional radiography, CT, Audit and standards, Health policy and practice, Radiation safety, Outcomes, Quality assurance
Purpose The purpose of the study was to retrospectively compare the clinically significant positive and negative rates of cervical spine imaging (imaging characteristics) in the Emergency Department (ED) based on the imaging recommendations from the American College of Radiology (ACR) Appropriateness Criteria (AC), the European Society of Radiology (ESR) iGuide, and the Royal College of Radiologists (RCR) iRefer and, in tandem, explore the subsequent patient disposition.
Read more Methods and materials BackgroundDiagnostic imaging in the emergency department (ED) is experiencing an upward trajectory in terms of utilisation [1]. The associated effects of ionising radiation, as well as the higher cumulative risk from examinations such as  radiography and computed tomography (CT), are concerning [2]. Imaging referral guidelines empower clinicians to make appropriate imaging referrals by providing imaging recommendations for specific clinical scenarios.However, different imaging guidelines employed distinct methodologies for their content, resulting in varying imaging recommendations [3,4].  The inclusion and/or exclusion of...
Read more Results Study populationDuring the 3-month study period, 452 cervical spine X-ray and 153 CT cervical spine were performed within the ED, averaging six imaging referrals a day. The mean age of patients who underwent cervical spine X-ray was 56.0 (17.3 SD) years and 52.8 (21.4 SD) years for CT cervical spine, with a slight female preponderance (n = 248/452; 54.9%) for cervical spine X-ray and a male preponderance (n = 100/153; 65.4%) for CT cervical spine.Cervical Spine Imaging (Conventional radiography and...
Read more Conclusion There was variation in the rates of positive significant findings within all the imaging recommendations for cervical spine, with CT identifying a higher number of these positive findings as compared to X-rays. Inappropriate cervical spine imaging was associated with lack of positive significant findings. When imaging is considered inappropriate, imaging referral guidelines can effectively exclude clinically significant injury due to their high specificity. Furthermore, the analysis of patient dispositions suggests that we can omit most of this low-value imaging and...
Read more References Poyiadji N, Beauchamp N, 3rd, Myers DT, Krupp S, Griffith B. Diagnostic Imaging Utilization in the Emergency Department: Recent Trends in Volume and Radiology Work Relative Value Units. J Am Coll Radiol. 2023;20(12):1207-14. Mataac MT, Li X, Rehani MM. What proportion of CT scan patients are alive or deceased after 10 years? Eur J Radiol. 2024;178:111629. European Society of R. Methodology for ESR iGuide content. Insights Imaging. 2019;10(1):32. Remedios D, France B, Alexander M. Making the best value of clinical radiology: iRefer Guidelines,...
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