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Published in: Japanese Journal of Radiology 11/2017

01-11-2017 | Original Article

Appropriate imaging utilization in Japan: a survey of accredited radiology training hospitals

Authors: Kanako K. Kumamaru, Sadayuki Murayama, Yasuyuki Yamashita, Takeshi Nojo, Yoshiyuki Watanabe, Mariko Goto, Eriko Maeda, Junko Echigo, Shigeyoshi Soga, Shinya Fujii, Yutaka Tanami, Tetsuhiko Okabe, Masahiro Okada, Jiro Munechika, Hideki Ota, Mototaka Miyake, Hiroshi Honda, Shigeki Aoki

Published in: Japanese Journal of Radiology | Issue 11/2017

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Abstract

Purpose

To survey whether imaging is being performed appropriately in Japan, and to survey whether radiologists intervene to ensure imaging requests are appropriate.

Methods

An online survey was sent to radiologists at accredited radiology training hospitals. The survey included the radiologists’ perspectives on whether imaging is performed appropriately at their institutions and whether they intervene if the indication for imaging is inappropriate/ambiguous.

Results

The response rate was 87.3% (165/189). We observed marked variability in the frequencies that imaging not recommended by the guidelines was performed among modalities and/or body parts; the responses “very frequently/frequently performed” were more common for breast cancer related imaging examinations and for head CT/MRI. The respondents frequently reported that inappropriate/ambiguous indications included requests to expand the craniocaudal range or to perform whole-body imaging. In 80% of the hospitals (132/165), radiologists contacted the physicians who requested unrecommended examinations; the number of CT and MRI examinations that full-time radiologists need to interpret in a half-day session was significantly smaller at these hospitals (median 18 vs 24, P = 0.032).

Conclusion

We conducted a survey to investigate appropriate imaging utilization in Japan. At the hospitals with numerous examinations to interpret, full-time radiologists may find it difficult to ensure that examinations are ordered appropriately.
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Literature
1.
go back to reference Brkljačić B. Summary of the proceedings of the international forum 2016: “Imaging referral guidelines and clinical decision support—how can radiologists implement imaging referral guidelines in clinical routine?” Insights Imaging. 2017. doi:10.1007/s13244-016-0523-4. Brkljačić B. Summary of the proceedings of the international forum 2016: “Imaging referral guidelines and clinical decision support—how can radiologists implement imaging referral guidelines in clinical routine?” Insights Imaging. 2017. doi:10.​1007/​s13244-016-0523-4.
4.
go back to reference Yamashita Y, Murayama S, Okada M, Watanabe Y, Kataoka M, Kaji Y, et al. The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline. Jpn J Radiol. 2016;34(1):43–79.CrossRefPubMed Yamashita Y, Murayama S, Okada M, Watanabe Y, Kataoka M, Kaji Y, et al. The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline. Jpn J Radiol. 2016;34(1):43–79.CrossRefPubMed
6.
go back to reference Kumamaru KK, Kumamaru H, Bateman BT, Gronsbell J, Cai T, Liu J, et al. Limited Hospital Variation in the Use and Yield of CT for Pulmonary Embolism in Patients Undergoing Total Hip or Total Knee Replacement Surgery. Radiology. Radiological Society of North America; 2016;281:826–34. Kumamaru KK, Kumamaru H, Bateman BT, Gronsbell J, Cai T, Liu J, et al. Limited Hospital Variation in the Use and Yield of CT for Pulmonary Embolism in Patients Undergoing Total Hip or Total Knee Replacement Surgery. Radiology. Radiological Society of North America; 2016;281:826–34.
7.
go back to reference Rao VM, Levin DC. The overuse of diagnostic imaging and the Choosing Wisely initiative. Ann Intern Med. 2012;157(8):574–6.CrossRefPubMed Rao VM, Levin DC. The overuse of diagnostic imaging and the Choosing Wisely initiative. Ann Intern Med. 2012;157(8):574–6.CrossRefPubMed
8.
go back to reference Alvarez S, Añorbe E, Alcorta P, López F, Alonso I, Cortés J. Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review. AJR Am J Roentgenol. 2006;186(5):1342–8.CrossRefPubMed Alvarez S, Añorbe E, Alcorta P, López F, Alonso I, Cortés J. Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review. AJR Am J Roentgenol. 2006;186(5):1342–8.CrossRefPubMed
9.
go back to reference NCCN. NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Breast cancer. Version 1.2016. 2016. p. 1–191. www.nccn.org/patients. Accessed 25 Aug 2017. NCCN. NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Breast cancer. Version 1.2016. 2016. p. 1–191. www.​nccn.​org/​patients. Accessed 25 Aug 2017.
10.
go back to reference Douglas AC, Wippold FJ, Broderick DF, Aiken AH, Amin-Hanjani S, Brown DC, et al. ACR appropriateness criteria headache. J Am Coll Radiol. 2014;11(7):657–67.CrossRefPubMed Douglas AC, Wippold FJ, Broderick DF, Aiken AH, Amin-Hanjani S, Brown DC, et al. ACR appropriateness criteria headache. J Am Coll Radiol. 2014;11(7):657–67.CrossRefPubMed
11.
go back to reference Frishberg BM. The utility of neuroimaging in the evaluation of headache in patients with normal neurologic examinations. Neurology. Lippincott Williams & Wilkins. 1994;44(7):1191–7. Frishberg BM. The utility of neuroimaging in the evaluation of headache in patients with normal neurologic examinations. Neurology. Lippincott Williams & Wilkins. 1994;44(7):1191–7.
13.
go back to reference Chou R, Qaseem A, Owens DK, Shekelle P. Clinical guideline: Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011;154:181–90.CrossRefPubMed Chou R, Qaseem A, Owens DK, Shekelle P. Clinical guideline: Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011;154:181–90.CrossRefPubMed
14.
go back to reference Patel ND, Broderick DF, Burns J, Deshmukh TK, Fries IB, Harvey HB, et al. ACR appropriateness criteria low back pain. J Am Coll Radiol. 2016;10:69–78. Patel ND, Broderick DF, Burns J, Deshmukh TK, Fries IB, Harvey HB, et al. ACR appropriateness criteria low back pain. J Am Coll Radiol. 2016;10:69–78.
16.
go back to reference Kumamaru KK, Hunsaker AR, Kumamaru H, George E, Bedayat A, Rybicki FJ. Correlation between early direct communication of positive CT pulmonary angiography findings and improved clinical outcomes. Chest. 2013;144(5):1546–54.CrossRefPubMed Kumamaru KK, Hunsaker AR, Kumamaru H, George E, Bedayat A, Rybicki FJ. Correlation between early direct communication of positive CT pulmonary angiography findings and improved clinical outcomes. Chest. 2013;144(5):1546–54.CrossRefPubMed
17.
go back to reference Kumamaru KK, Kondo T, Kumamaru H, Amanuma M, George E, Rybicki FJ. Repeat coronary computed tomographic angiography in patients with a prior scan excluding significant stenosis. Circ Cardiovasc Imaging. 2014;7(5):788–95.CrossRefPubMed Kumamaru KK, Kondo T, Kumamaru H, Amanuma M, George E, Rybicki FJ. Repeat coronary computed tomographic angiography in patients with a prior scan excluding significant stenosis. Circ Cardiovasc Imaging. 2014;7(5):788–95.CrossRefPubMed
18.
go back to reference Nakajima Y, Yamada K, Imamura K, Kobayashi K. Radiologist supply and workload: international comparison—working group of Japanese College of Radiology. Radiat Med–Med Imaging Radiat Oncol. 2008;26(8):455–65. Nakajima Y, Yamada K, Imamura K, Kobayashi K. Radiologist supply and workload: international comparison—working group of Japanese College of Radiology. Radiat Med–Med Imaging Radiat Oncol. 2008;26(8):455–65.
19.
go back to reference Nishie A, Kakihara D, Nojo T, Nakamura K, Kuribayashi S, Kadoya M, et al. Current radiologist workload and the shortages in Japan: how many full-time radiologists are required? Jpn J Radiol. 2015;33(5):266–72.CrossRefPubMed Nishie A, Kakihara D, Nojo T, Nakamura K, Kuribayashi S, Kadoya M, et al. Current radiologist workload and the shortages in Japan: how many full-time radiologists are required? Jpn J Radiol. 2015;33(5):266–72.CrossRefPubMed
Metadata
Title
Appropriate imaging utilization in Japan: a survey of accredited radiology training hospitals
Authors
Kanako K. Kumamaru
Sadayuki Murayama
Yasuyuki Yamashita
Takeshi Nojo
Yoshiyuki Watanabe
Mariko Goto
Eriko Maeda
Junko Echigo
Shigeyoshi Soga
Shinya Fujii
Yutaka Tanami
Tetsuhiko Okabe
Masahiro Okada
Jiro Munechika
Hideki Ota
Mototaka Miyake
Hiroshi Honda
Shigeki Aoki
Publication date
01-11-2017
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 11/2017
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-017-0677-0

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