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E1991. Assessment of the Referring Physicians Response to CT Abdomen and Pelvis Report Recommendations
Authors
  1. Shaza AlSharif; King Abdulaziz Medical City; King Saud bin Abdulaziz University for Health Sciences University
  2. Ghalib Alasaad; King Saud bin Abdulaziz University for Health Sciences University
  3. Mohammed Bukhari; King Saud bin Abdulaziz University for Health Sciences University
  4. Abdulaziz Sharkar; King Saud bin Abdulaziz University for Health Sciences University
  5. Mohammed Altaf; King Saud bin Abdulaziz University for Health Sciences University
  6. Khalid Alshamrani; King Saud bin Abdulaziz University for Health Sciences University
  7. Shaymaa Malibari; King Faisal Residential City Clinic
Objective:
Radiology reports are one form of fundamental communication between radiologists and treating physicians. One vital part of the report is radiologist recommendation which may be additional imaging, laboratory test or further investigation. The aim of the study is to assess the response rate of physicians to the recommendation in the radiology reports.

Materials and Methods:
The study is a retrospective cohort quantitative chart review. All patient's files who underwent a CT-abdomen and pelvis (CTAP) between October 1, 2017 and December 31, 2017 and received recommendations for further evaluation were reviewed and included in the study. Patients younger than 14-years, those that performed the CTAP from an outside institution with no attached report and patients with missing information relevant to the study were excluded. The data collection and entry were performed through Microsoft Excel sheet, and were analyzed using Minitab and IBM SPSS.

Results:
A total number of 413-CTAP reports with 523-recommendations were included in the study with mean age of 55.14±17.39-years. 244(59.1%) are females and 169(40.9%) are males. Patients undergoing CTAP were referred from Oncology-Department N=124(30.02%), Emergency-department N=76(18.40%), Gastroenterology-department N=31(7.51%), Surgery-department N=30(7.26%). Surgery-department received more recommendations than other departments. Categorically divided, the most common type of further evaluation recommended was further imaging N=410(78.39%). Further lab evaluation N=60(11.47%), non-imaging procedures N=37(7.07%) and specialty referrals N=16(3.06%). The renal-system received the most radiology report recommendations for further evaluation N=111(21.23%), the hepatobiliary-system N=101(19.31%) and the genitourinary-system N=88(16.83%). N=158(30.21%) of the recommendations were in the same organ-system as the CTAP indication and N=358(68.45%) of the recommendations were not in the same organ system. Of the 523-radiology-recommendations N=278(53.15%) were not performed and N=245(46.85%) were performed. N=202(38.62%) of the recommendations were performed within 6 months and N=43 recommendations were performed within more than 6-months. N=199(71.58%) of the recommendations not performed did not have a documented rationale. N=58(20.86%) were not performed because an alternative study was done. N=12(4.32%) were not performed because the study was already performed before CTAP. Recommendations that were done were compared with whether the recommendations were in the same system as the CTAP-indication with a likelihood ratio of 4.106, DF=1, CI=95%, p-value=0.043. Recommendations that were done were also compared with the type of further evaluation recommended with a likelihood ratio of 17.841, DF=3, CI=95%, p-value=0.001.

Conclusion:
This study highlights the need for implementing guidelines to use more structured reporting style, verbal or non-verbal communications such as automatically generated emails or text messages to the referring physicians to increase the follow-up of recommendations chances.