To do, or not to do, that is the question: Appropriateness of the Requested CT and MR Imaging Studies in the Philippine General Hospital Outpatient Department Based on the American College of Radiology Appropriateness Criteria

Abstract

Objective. To determine the rate of the appropriateness of the requested CT and MRI procedures in the Outpatient Department of a tertiary hospital in the Philippines from January to June 2018 using the American College of Radiology Appropriateness Criteria (ACR-AC).

Methods. This retrospective research reviewed outpatient CT and MR imaging requests and cross-referenced with the corresponding ACR-AC guideline available for the written clinical diagnosis.

Results. Four hundred thirty-six (436) (56%) of the 774 retrieved requests were CT scan studies, while the remaining 338 (44%) are MR imaging procedures. Cross-referencing withACR-AC, the rate of appropriateness across all patients is high at 96.6%, with a 95% confidence interval of 95.0% and 97.6%. The rates were not significantly different between MRI and CT (p-value = 0.4502). Likewise, there was no significant difference in rates of appropriateness for the body parts abdomen, cranial, chest, and spine (p-value = 0.6502).

Conclusion. Although the results were high, relative to the few available international studies, the importance and potential of the ACR-AC cannot be disregarded. The ACR-AC serves as a guide in selecting the appropriate imaging test given a clinical situation. This may equate to better patient management, considering all patient-related factors.