Abstract
PurposeTo investigate temporal changes in the utilization and patient impact of abdominal CT during duty shifts in the past 15 years.MethodsThis study included a random sample of 1761 abdominal CT scans that were made during evening and night duty shifts in a tertiary care center between 2005 and 2019.ResultsThe number of CT scans significantly increased (almost threefold) between 2005 and 2019 (Mann–Kendall tau of 0.829, P < 0.001). The proportion of negative CT scans (i.e., the absence of findings related to the reason that the CT scan was made and no disease deterioration or other new and clinically relevant findings compared to a previous imaging examination when available) was 40.0% (700/1749) in the entire 15-year study frame and did not significantly change over time (Mann–Kendall tau of − 0.219, P = 0.276). The overall frequency of same-day hospital discharge after negative CT was 20.6% (150/729) in the past 15 years and showed a significant increase over time (Mann–Kendall tau of 0.505, P = 0.010). The overall proportion of CT scans with incidental findings was 3.4% (60/1761) and remained statistically stable over the past 15 years (Mann–Kendall tau of − 0.057, P = 0.804).ConclusionOver the past 15 years, the number of CT scans and the frequency of same-day hospital discharge after negative CT have increased, while the proportions of negative CT scans and incidental findings have remained stable in our tertiary care center. The data from this study can be used for interinstitutional benchmarking to define, monitor, and improve the appropriateness of imaging utilization.
Highlights
Medical imaging plays a crucial role in personalized medicine [1]
1861 abdominal computed tomography (CT) scans were made during the evening and night duty shifts on the 102 randomly selected calendar days in the years 2005 to 2019
It should be emphasized that these 1761 abdominal CT scans reflect the data sample and not the absolute true number of scans performed over the time frame
Summary
Medical imaging plays a crucial role in personalized medicine [1]. Not surprisingly, the number of medical imaging examinations has increased considerably in the Western world over the past two decades, and this applies to the utilization of computed tomography (CT) [2, 3]. The growth in medical imaging has yielded unarguable benefits to patients in terms of longer lives of higher quality [2]. A CT scan in a patient with abdominal complaints and the clinical suspicion of appendicitis but without any imaging findings that can explain the symptoms, and a CT scan in another patient with an already known intra-abdominal abscess and the clinical suspicion of abscess growth but with stable imaging findings, can both be considered as negative imaging examinations. High proportions of negative imaging examinations reflect imaging overutilization. Benchmarks have to be established for the acceptable proportion of negative studies [5]. Such benchmarks may be used as key performance indicators of healthcare quality.
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