Abstract
Plain abdominal radiography is believed to be over utilized as an investigation for acute abdominal complaints. Because of this, the Royal College of Radiologists published guidelines in order to minimise inappropriate requests. The aims of this research were to determine the level of referring clinicians’ adherence to these guidelines while making referrals, to determine whether professional status of the referring clinicians influences their adherence to the guideline, and finally to ascertain if abdominal radiography contribution to patients’ diagnosis is influenced by adherence to the guidelines. In this study, 206 referrals for abdominal radiography with clinical indication that fell within the guidelines were retrospectively collected and analysed. Initial clinical indications were compared with the indications in the guidelines. Also, requests were also analysed according to the professional status of the referring clinicians, and finally, adherence to the guidelines was compar
INTRODUCTION
The performance of plain abdominal radiography is often considered to be an essential requirement for assessing acute abdominal complaints. It is commonly requested for acute medical emergences on patients with non-specific abdominal symptoms and signs
1
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Often, plain abdominal radiography is requested routinely as part of the initial investigation on the day of admission, mainly by admitting junior doctors who may not be fully aware of the indications or appreciate the limitations of this investigation towards making diagnosis.
There are only few indications in which the plain abdominal radiography is helpful, such as small bowel obstruction
2
. Majority of the conditions where these exams were performed have been taken over by newer modalities such as ultrasonography. In addition, only few doctors are aware of the relative high radiation dose patient is exposed to while undergoing plain abdominal radiography.Patient undergoing plain abdominal radiography receives 35 times the dose they receive during normal chest radiography
3
. The limitations of plain abdominal radiography are consistently demonstrated in several series where the percentage of diagnostic radiography ranges only 10-20%
4,5,6, 7. Inorder to minimize inappropriate requests, unnecessary radiation dose to the patient and to enhance the efficiency of this investigation, the Royal College of Radiologists (RCR) issued out clear guidelines for requesting for plain abdominal radiography8
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- There is doubt whether the referring clinicians in our hospitalsadhere to the guidelines given by the Royal College of Radiologist for abdominal radiography.
- It is not certain if abdominal radiography contribution towards patients’ diagnosisis associated with adherenceto the guidelines.
- It is not known whether the referring clinicians’ adherence to the Royal College of Radiologists guidelines is associated with their professional status.
1.3 OBJECTIVE OF THE STUDY
- To find out if referring clinicians adhere to the Royal College of Radiologists’ guidelines for abdominal radiography.
- To determine if abdominal radiography contribution to patients’ diagnosisis associatedwith adherence to the guidelines.
- To find out if professional status of the referring clinicians is associated with their adherence to the guidelines.
1.4 SIGNIFICANCE OF THE STUDY
The results of the study may assist health policy makers
in developing guidelines for routine plain abdominal radiography utilizations in our locality
This study was carried out on all the patients referred for abdominal radiography at NnammdiAzikiweuniversity teaching hospital (NAUTH), Nnewi, from 2001 to 2011.