Maria Twomey MBChB, FFR(RCSI), Presenter: Nothing to Disclose

Fiachra Gerard Moloney MBBCh, MRCPI, Abstract Co-Author: Nothing to Disclose

Jennifer Sammon MBBCh, Abstract Co-Author: Nothing to Disclose

Jennifer Murphy MBBCh, MRCPI, Abstract Co-Author: Nothing to Disclose

Kevin Noel O Regan MD, Abstract Co-Author: Nothing to Disclose

Michael M. Maher MD, FRCR, Abstract Co-Author: Nothing to Disclose

Accurate clinical information is paramount for the radiologist to accurately prioritise, protocol and report an imaging study. The purpose of this study was to investigate the rate of erroneous biochemical and haematological parameters as detailed on electronic requests for CTPA, CT Thorax and abdominopelvic CT.

A total of 250 electronic requests submitted on a radiology information system over a 6 month period(July -Dec2013) performed in a single institution were randomly selected comprising 100 CTPA, 70 CT TAP and 80 abdominopelvic CT. The creatinine level, haemoglobin level, CRP and WCC levels supplied for each patient by the referring clinician were compared to the reported levels on our institutions biochemical and haematology electronic reporting system.In the CTPA subgroup d-dimer levels and pO2levels were also compared.The level of experience of the referring clinician and the referring department were also recorded.  

Overall 45% of the total 250 requests contained erroneous biochemical and/or haematological information.CTPA requests had a significant number of erroneous D-dimer and pO2 levels; 15% reported an abnormal D-dimer result when the actual reported result was normal.A further 25% had reported hypoxia when the reported pO2 was normal. 10% of all requests contained an incorrect normal creatinine level. 30% of  abdominopelvic CT requests detailed a low haemoglobin with iron deficiency anaemia, however the formal reported results were normal or revealed a normochromic normocyctic anaemia in 75%. Elevated CRP and/or WCC were reported in 70% of acute abdominopelvic CT requests; 20% of the formal results in this subgroup were normal.A significantly higher incidence of erroneous parameters were supplied by medical physician referrals as opposed to surgeons.    

This study reveals a high level of erroneous clinical information on electronic requesting which may result in inappropriate prioritisation, protocolling and administration of iv contrast and may effect the accuracy of the consequent radiology report.

Accurate clinical information is essential to enable informed judgment on patient exposure to radiation. The level of erroneous information in this study raises concern; clinicians must be made aware that providing incorrect information is potentially deleterious to patient mangement and does not foster productive professional colleague interaction.  

Twomey, M, Moloney, F, Sammon, J, Murphy, J, O Regan, K, Maher, M, The Truth Behind the Fiction: Erroneous Clinical Information in Electronic Radiology Requests.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017747.html