Source:Academic Radiology
Author(s): Travis B. Wassermann, Christopher M. Straus
Rationale and ObjectivesComplete clinical information improves the diagnostic capacity of medical imaging, and the radiology requisition is the radiologist's primary means of receiving clinical information. This study aimed to characterize trends in the quality of clinical information in radiology requisitions at an academic medical center between 2011 and 2016.Materials and MethodsThis institution's requisition form includes two questions: "Signs and Symptoms:" and "Clinical Question to be answered…:" Requisitions for three studies (CT UPPER ABDOMEN & PELVIS W, CT HEAD WO, and XR PORT CHEST, 1 VIEW) from three selected months were individually rated in four categories of clinical information. Additionally, requisitions for 13 study types were evaluated for character count and for the proportion of requisitions with identical answers to the two questions. A total of 3250 requisitions were individually rated.ResultsThere was a decline in the quality of clinical questions in computed tomography requisitions (P = 0.016) and a decline in the quality of medical history in chest x-ray requisitions (P < .001). Of the 13 study types, nine had more than 1000 total requisitions (total n = 260,617). Of those nine studies, six showed trends of increasing character length (P < .001 for each). Four showed an increasing proportion of identical answers to the two questions (P < .001), and one showed a decreasing proportion of identical answers (P < .001).ConclusionsThis decline in the quality of clinical information is concerning. Whether it is due to increasing time pressures, a shift in the attitudes of ordering providers, or any other cause, this study demonstrates a declining trend in the quality of communication via the radiology requisition.
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