The use of cross-sectional diagnostic imaging in a major Canadian health care center

To assess current patterns of use of cross-sectional imaging at 5 large Canadian teaching hospitals and a cancer centre, in order to better predict future use. We prospectively reviewed all requisitions for diagnostic imaging during a 2-week period in January 2002. Each requisition was assessed by means of a form on which the attending radiologist answered 6 questions about the appropriateness and usefulness of the requested examination. A total of 2374 examinations were audited: 1167 ultrasonography, 925 computed tomography and 282 magnetic resonance imaging examinations. Forms with scores of 3 out of 7 or more for the appropriateness and relevance of the imaging request (n = 2229) were not examined further. After review of the remaining complete forms, 59 (2.5%) were found to contain at least 1 score that was less than 3 out of 7, which was considered to be a failing grade. There is a low incidence of inappropriate use of diagnostic imaging. Practical ways to reduce u necessary use would include close attention to the wasteful practice of test duplication and to the need for patient education to help minimize unnecessary testing. (author)