Clinical evaluation of the benefit of radiologic examinations by means of diagnostic value, therapeutic value and reliability index

An effective use of the capacities of diagnostic radiology can be improved only by an exact calculation of the clinical outcome of X-ray examinations. This cannot be achieved by incorrect formulations such as 'diagnostic' and 'therapeutic' relevance being inconsistent with our contemporary state of knowledge. A concept for determining the clinical benefit, that has been proven in basic medical care for more than 7,000 patients, is demonstrated. The evaluation of data for sample sizes over 200 requires computer assistance. The derived parameters of efficacy: diagnostic value, therapeutic value and reliability index evaluate the clinical benefit of the radiologic examination. Decisive is a prospective interdisciplinary collection of the data that must be obtained parallel to the clinical evaluation of the findings. The efficacy parameters are explained by examples of posttraumatic diagnosis of skull and limbs. They facilitate an estimation of the value of all radiographic findings, normal or pathological, and therefore the detection of a critical or uncritical indication behavior. The parameters characterize groups of patients and serve as a scientific basis for the analysis and improvement of diagnostic efficacy. (author)