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Utilization of Diagnostic Radiologic Examinations in the Emergency Department of a Teaching Hospital

 

作者: MICHAEL ELIASTAM,   ELLIOTT ROSE,   HENRY JONES,   ERNEST KAPLAN,   ROBERT KAPLAN,   ADAM SEIVER,  

 

期刊: The Journal of Trauma: Injury, Infection, and Critical Care  (OVID Available online 1980)
卷期: Volume 20, issue 1  

页码: 61-66

 

ISSN:0022-5282

 

年代: 1980

 

出版商: OVID

 

数据来源: OVID

 

摘要:

&NA;A study to document the utilization by house officers of the Diagnostic Radiologic Examination (DRE) in trauma patients was carried out over 2 years at Stanford University Medical Center. Physicians recorded the likelihood of a fracture being present for patients requiring DRE's to evaluate traumatic injuries. The physician's opinion and the radiologist's final interpretation of the DRE were compared for 24 anatomic regions. Preliminary findings reveal: for almost half the DRE's the house officer indicated that the reason for the DRE was medicolegal; 7% of the medicolegal cases had fractures present; less than 4% of these fractures was important enough to change the medical treatment. The levels of house officer experience are suggested as possible causes of excessive DRE utilization, as well as the influence of defensive medicine. Using Green and Swets' Theory of Signal Detection, it is possible to mathematically describe an accuracy index, and a “fear” index for each physician. We plan to use this model in analysis of the study data.

 

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