Assessment of the completeness of medical imaging request forms in a sub-Saharan African setting

Abstract

The technical quality, interpretation, and clinical utility of diagnostic imaging examinations can increase considerably when the request forms are correctly filled out. This study sought to evaluate the completeness of these request forms at the Women and Children's Hospital in Yaoundé, Cameroon, to the 8 criteria established by the French High Health Authority (HAS, France). This cross-sectional study evaluated 118 request forms for ultrasounds, 110 for conventional radiography, and 34 for computed tomography (CT scans), all completed by physicians at our university-affiliated hospital. They were sampled consecutively three days a week for several weeks, on days randomly selected at the beginning of each week, to minimize bias and ensure that as many different physicians as possible were assessed. We doubled the sample size recommended by the HAS. Conformity was defined by the presence of the required data on the request forms (data classified as either administrative or clinical). Overall, 52 request forms (19.8%) had all 5 administrative items, but only 9.2% had all 3 clinical components. Only 3 forms (1.1%) were 100% complete, including all 8 items; 85% included at least 5 components, and 35.1% had 6. The patient's last name was always included. Only 4.2% of the request forms included the prescriber's telephone number; 8% did not include the date and 17.2% (n = 45) did not state the clinical findings. On 30% of the forms, symptoms were the only clinical information listed; 23.7% (n = 62) stated the purpose of the examination (that is, the diagnosis to be confirmed or ruled out). The rate of missing information was highest in the requests for conventional radiography (49.5% compared to 38% with ultrasound and 12.3% for CT scans). The request forms for imaging examinations provided inadequate administrative and clinical data, especially those for conventional radiography. This missing information makes it harder to perform and interpret these examinations. An electronic request form with mandatory fields might improve the overall quality of the forms.