A significant number of patients sent to a large academic medical center by their primary-care doctors for MRI, CT and PET scans were referred for symptoms that did not meet evidence-based criteria, according to a study in the March issue of the Journal of the American College of Radiology.
The study, performed at Seattle-based Harborview Medical Center, looked at medical records of 459 patients who were referred by their primary-care doctors to the hospital's outpatient imaging center for diagnostic CT, MRI or PET scans. Researchers found that 26% of the referrals were considered inappropriate because they did not meet criteria established by a radiology benefits management company whose guidelines closely resemble those created by the American College of Radiology. Twenty-four percent of the inappropriate scans resulted in findings that affected prescribed treatment compared to 58% of the appropriate studies resulting in findings that affected treatment decisions.
Robert Bree, lead author of the study, said in a news release that the findings “suggest a need for tools to help primary-care physicians improve the quality of their imaging decision requests.” Inappropriate referrals identified by the study included prescribing a CT brain scan for chronic headache and a knee MRI for a patient with osteoarthritis.