Retrospective Evaluation of X-ray Ordering Practices and Diagnostic Accuracy in Emergency Care

Abstract

Over-utilisation and under-utilisation of imaging are not uncommon, even in clinical environments driven by acute decision-making (Parpaleix et al., 2023). Existing literature on X-ray ordering presents little information about an delivering wider and safe environment and accurate care. Diagnostic performance metrics for radiographs requested in response to patients’ initial presenting complaints in Emergency Departments (EDs)—a topic of interest in the context of imaging over-and under-utilisation—have also not been published (Brown et al., 2019). Emergency imaging studies concerning diagnostic yield do not report the referring doctor’s examination or the requesting documentation pertaining to the images.

The primary motivation for this work was the development of a state-of-the-art X-ray ordering decision-support tool for EDs. Relationships between clinical and imaging variables and relevant diagnostic outcomes were established to aid decisions about which additional information would assist clinicians in selecting appropriate additional images. Ordering Guidance based on publicly available references could then be contemplated and requirements for other reminders could be envisaged. This study outlines an X-ray ordering Retrospective Evaluation of Ordering Practices and Diagnostic Accuracy in Emergency Care because gathering the associated data represented a preliminary activity for these investigations.