Authors' objectives:

The aim of this review was 1) to describe the indications of CT and MRI requested by primary care and managed by the Catalan Health Institute, and 2) to describe the geographical variations of the utilisation rates of CT and MRI in primary care.

Authors' results and conclusions: The total number of CT requests included was 12,710 and the most frequent reasons were related to the spine, the Central Nervous System (CNS) and sensory organs, as well as chest diseases. 68.5% of column requests corresponded to the diagnosis of back pain/lumbar discopathy, followed by 16.2% pertaining to cervical/brachialgia/cervical discopathy. The most frequent diagnoses among the diseases of the CNS and sensory organs were headache (31.2%) and symptoms related to cognitive disorders (21.8%). In the study period, 2,366 doctors requested some type of CT exploration. The number of MR explorations requested was 6,251. Diseases of the musculoskeletal apparatus, the spine and the SNC and sensory organs were the most frequent reasons for request. Among the diseases of the musculoskeletal apparatus, gonalgia/meniscopathy accounted for 49.7% of requests, followed by lesion of the rotator cuffs (5.2%). 55.3% and 23.9% of the column requests referred to the diagnosis of unspecific lumbalgia and/lumbar discopathy and cervico/brachialgia/cervical discopathy, respectively.

Authors' recommendations: The results of this study suggest that in the sphere of PC managed by the Catalan Institute of Health, a high percentage of the demand for CT and MR explorations comes from a reduced number of indications and specialities, although there is wide variability in the PCS-adjusted rates. In most requests, the information provided to the radiologist is scant. Therefore, strategies targeting improving the adaptation of the indications for these explorations should focus on the most frequent reasons for requesting them, standardising the approach (clinical practice guidelines), whereas, and moreover, minimum clinical (structured) information requirements must be defined for the conduct and interpretation of the test.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.gencat.net/salut/depsan/units/aatrm/html/en/dir393/doc7921.ht ml

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Qualitat i Avaluacio Sanitries de Catalunya

Contact Address: Antoni Parada, CAHTA, Roc Boronat, 81-95 (2nd floor), 08005 Barcelona, Spain, Tel. +34 935 513 928, Fax: +34 935 517 510

Contact Name: direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net

Contact Email: direccio@aatrm.catsalut.net / aparada@aatrm.catsalut.net

Copyright: Catalan Agency for Health Technology Assessment and Research (CAHTA)