An audit of clinical practice, referral patterns, and appropriateness of clinical indications for brain MRI examinations: A single-centre study in Ghana

Piersson, Albert Dayor; Nunoo, G.; Gorleku, Philip Narteh

doi:10.1016/j.radi.2017.10.004

Cited by 9 publications

(12 citation statements)

References 20 publications

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“…1: Identical study results [100] of children and adult CT lead to a total overlap of bubbles in head/neck imaging. 2: Similar study results of adult MRI [93,101] and adult CT [75] lead to a partial overlap of bubbles in head/neck imaging. CT Computed tomography.…”

Section: Heart/vesselsmentioning

confidence: 64%

“…[63] to 1000 [105] records per study. 1500 (89%) head/neck MRIs were rated appropriate ranging between 81% (n = 130/161) [75] over 88% (n = 882/1000) [105] to 97% (n = 239/247) [80] study individual appropriateness. Three studies [74,79,80] reviewed 315 pediatric MRIs with an overall appropriateness of 92% ranging between 92 [74,79] and 89% [80].…”

Section: Resultsmentioning

confidence: 99%

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Measuring appropriateness of diagnostic imaging: a scoping review

et al. 2023

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In radiology, the justification of diagnostic imaging is a key performance indicator. To date, specific recommendations on the measurement of appropriateness in diagnostic imaging are missing. To map the study literature concerning the definition, measures, methods and data used for analyses of appropriateness in research of diagnostic imaging. We conducted a scoping review in Medline, EMBASE, Scopus and the Cochrane Central Register of Controlled Trials. Two independent reviewers undertook screening and data extraction. After screening 6021 records, we included 50 studies. National guidelines (n = 22/50) or American College of Radiology Appropriateness Criteria (n = 23/50) were used to define and rate appropriateness. 22/50 studies did not provide methodological details about the appropriateness assessment. The included studies varied concerning modality, amount of reviewed examinations (88–13,941) and body regions. Computed tomography (27 studies, 27,168 examinations) was the most frequently analyzed modality, followed by magnetic resonance imaging (17 studies, 6559 examinations) and radiography (10 studies, 7095 examinations). Heterogeneous appropriateness rates throughout single studies (0–100%), modalities, and body regions (17–95%) were found. Research on pediatric and outpatient imaging was sparse. Multicentric, methodologically robust and indication-oriented studies would strengthen appropriateness research in diagnostic imaging and help to develop reliable key performance indicators.

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Section: Heart/vesselsmentioning

confidence: 64%

Section: Resultsmentioning

confidence: 99%

Measuring appropriateness of diagnostic imaging: a scoping review

et al. 2023

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“…For counselling purposes of the patient, an internal literature screening on MRI with all bone-conduction hearing implants was performed and resulted in 34 studies with a total of 440 patients out of which 215 underwent 368 scans in total. 11,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Of the 215 patients with MRI scans, data of 82 patients were from Med-El, data of 70 patients were from Cochlear Limited, 22 were from Advanced Bionics, 4 were from Oticon, 6 were from the Technical University of Vienna, 11 were from Soundtec and 1 was from Xomed. None of the extracted studies reported pain, discomfort or abortion of the scans with the Bonebridge bone-conduction hearing implant 601 device, which is the precursor model of the implant investigated here.…”

Section: Discussionmentioning

confidence: 99%

Comparison of artefact reduction possibilities with the new active transcutaneous bone conduction implant (Bonebridge)

et al. 2022

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Objective This study aimed to evaluate the possibilities of artefact reduction using different anatomical implant positions with the Bonebridge bone-conduction hearing implant 602 for a patient with an acoustic neuroma requiring regular diagnostic magnetic resonance imaging of the tumour position. Method Three implant positions and magnetic resonance imaging examinations with and without customised sequences for metal artefact suppression were investigated. The diagnostic usefulness was rated by a radiologist (qualitative evaluation), and the relation between the area of artefact and the total head area was calculated (quantitative evaluation). Results Following the qualitative analysis, the radiologist rated the superior to middle fossa implant placement significantly better for diagnostic purposes, which is in agreement with the calculated artefact ratio (p < 0.0001). The customised slice-encoding metal artifact correction view-angle tilting metal artifact reduction technique sequences significantly decreased the relative artefact area between 5.13 per cent and 25.02 per cent. The smallest mean artefact diameter was found for the superior to middle fossa position with 6.80 ± 1.30 cm (range: 5.42–9.74 cm; reduction of 18.65 per cent). Conclusion The application of artefact reduction sequencing and special anatomical implant positioning allows regular magnetic resonance imaging in patients with the bone-conduction hearing implant 602 without sacrificing diagnostic imaging quality for tumour diagnosis.

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“…Researches which especially assessed the brain MRI appropriateness are few, so other MRI services are also compared with our findings. Piersson etal (2017) reported that about 19 percent of brain MRIs in a single center in Ghana were inappropriate (14). It seems the use of MRI procedure in Iran is similar to that of USA which has a very costly health system; because Lehnert & Bree (2010) found that 26% of MRI and CT prescriptions in USA are inappropriate (15).…”

Section: Discussionmentioning

confidence: 99%

Inappropriateness of brain MRI prescriptions and its financial burden

Kavosi

Sadeghi

Lotfi

et al. 2020

Preprint

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Background Diffusion of diagnostic tests such as (Magnetic Resonance Imaging) MRI is one of the main reasons for increasing growth of health care expenditure. So the current study aimed at estimation of the rate of brain MRI inappropriate prescriptions and their financial burden in Iran. Methods In this cross-sectional study 385 patients were selected by systematic stratified sampling in three public teaching hospitals in Shiraz, Iran. The selected participant's information was collected through data collection form which consisted of patients' demographic information, questions related to prescription and brain MRI prescription indications checklist. The completed indications checklist was compared to the appropriateness status table of indications and scenarios to detect the percent of appropriateness of prescriptions. Results About 21 percent of total brain MRI prescriptions are inappropriate. Previous treatment, number of refers to physician, having other diagnostic tests and the applicant of MRI (P<0.01) had significant relationships with prescriptions appropriateness. The estimated financial burden of inappropriate brain MRIs in Shiraz teaching hospitals was 99988 US dollar in 2017. Conclusions More than one fifth of brains MRIs were inappropriate. It caused about one hundred thousand United States Dollar (USD) financial burden which is 17 times of Iran's Gross Domestic Product (GDP) per capita. In order to better allocation of health system resources for provision of MRI services rationing policies for controlling consumer moral hazard and reducing provider induced demand can be helpful.

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An audit of clinical practice, referral patterns, and appropriateness of clinical indications for brain MRI examinations: A single-centre study in Ghana

Cited by 9 publications

References 20 publications

Measuring appropriateness of diagnostic imaging: a scoping review

Measuring appropriateness of diagnostic imaging: a scoping review

Comparison of artefact reduction possibilities with the new active transcutaneous bone conduction implant (Bonebridge)

Inappropriateness of brain MRI prescriptions and its financial burden

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