Preliminary experience of auditing in the assessment of GPs’ requests of imaging exams from a peripheral local health firm in Lazio, Italy

Abstract Study goals Many studies demonstrate that a significant amount of requested and performed imaging tests does not provide clinical information that could modify either patient clinical management or disease natural history, in particular, when clinical findings are omitted in an attempt to replace an accurate analysis of clinical findings and address diagnostic methods, examination for diagnostic imaging providers, thus lengthening the waiting time to perform tests that could impact on more serious disorders. The aim of this study is to determine prevalence of inappropriate studies among MR studies and prevalence of border-line studies among CT scans. Materials and methods A retrospective analysis of prescriptions recorded on the firm software was performed on CT and MR exams performed between January 1, 2023 and 30, June 2023. The assessment criteria were: presence of clinical question; presence of non-specific terms such as “assessment”, or “control” or “reassessment”, which were “a priori” considered inappropriate. In a subsequent phase, an audit was conducted with prescribing physicians to easily transmit pieces of information about critical issues and formulate appropriate solutions about indications and prescription appropriateness. Results Two hundred and thirty-seven MR exams and 277 CT exams were retrospectively assessed. Among MR exams, 44.76% of requests were not judged appropriate due to missing, non-specific or non-adequate questions. Among CT exams, 25.76% requests were judged inconsistent. Conclusions Results show a significant prevalence of imaging exams which are not useful in improving health status and quality of care of patients in the examined samples. This result is in line with literature findings. Due to patients’ safety, radiation protection issues, and economic impact, the issue deriving from such findings has to be seriously considered. Such results require confirmation by a more robust, prospective study based on larger samples that could allow us to confirm the effects of the audit intervention on general practitioners.