Enhance justification of medical exposures: a case study of completeness and vetting of CT requisitions for children and young adults in sub-Saharan Africa

Clinical information is of importance for justification of imaging procedures, strengthening radiation protection and improving appropriate utilisation of imaging resources. The purpose of this study was to assess the level of completeness of clinical information and vetting computerised tomography requisition forms (CTRFs). This was a retrospective review of all consecutive CTRFs for patients 35 years and below performed from 1 July through 31 December 2018 from six hospitals. Hard copies of CTRFs were reviewed for completeness of clinical information against a ‘standardised’ check list and whether vetted by a medical imaging practitioner (MIP). Data was descriptively analysed using STATA-14. The results were presented as proportions / frequencies /tables. Of the 972 CTRFs assessed, 464(47.7%) were from PNFP, 408(42%) public hospitals and 100 (10.3%) from PFP hospitals. All the CTRFs had incomplete clinical information. The fields with 100% information included patient's name, age and anatomical region to be scanned. Pregnancy status, renal functional tests and allergy status were the worst fields with no information at all and Only 18 (1.9%) CRFs were vetted by a MIP. There are low levels for clinical information completeness in sub-Saharan Africa. Strengthening justification of medical exposures and radiation protection is a shared responsibility by both the users and providers yet underestimated.