To do, or not to do, that is the question: Appropriateness of the requested CT and MR imaging studies in the Philippine General Hospital outpatient department based on the American College of Radiology Appropriateness Criteria

ABSTRACT

@#<p style="text-align: justify;"><strong>Objective:</strong> To determine the rate of the appropriateness of the requested CT and MRI procedures in the Outpatient Department of a tertiary hospital in the Philippines from January to June 2018 using the American College of Radiology Appropriateness Criteria (ACR-AC).</p><p style="text-align: justify;"><strong>Methods:</strong> This retrospective research reviewed outpatient CT and MR imaging requests and cross-referenced with the corresponding ACR-AC guideline available for the written clinical diagnosis.</p><p style="text-align: justify;"><strong>Results:</strong> Four hundred thirty-six (436) (56%) of the 774 retrieved requests were CT scan studies, while the remaining 338 (44%) are MR imaging procedures. Cross-referencing with ACR-AC, the rate of appropriateness across all patients is high at 96.6%, with a 95% confidence interval of 95.0% and 97.6%. The rates were not significantly different between MRI and CT (p-value = 0.4502). Likewise, there was no significant difference in rates of appropriateness for the body parts abdomen, cranial, chest, and spine (p-value = 0.6502).</p><p style="text-align: justify;"><strong>Conclusion:</strong> Although the results were high, relative to the few available international studies, the importance and potential of the ACR-AC cannot be disregarded. The ACR-AC serves as a guide in selecting the appropriate imaging test given a clinical situation. This may equate to better patient management, considering all patient-related factors.</p><p style="text-align: justify;"><strong>Key Words:</strong> diagnostic imaging; reviews, appropriateness; practice guideline</p>