Clinical value of body computed tomography over time and technologic change
- Harvard Univ., Boston, MA
A clinical study of body computed tomography (CT) at Massachusetts General Hospital evaluated 2619 patients who were prospectively assigned to one of 12 examination protocols. Data obtained from referring physicians and patient records just before CT examination and later in the course of care served as a basis for judging the contribution of CT to diagnostic understanding, use of other tests, and choice of therapy. Fifty-three percent of examinations produced a substantial or unique contribution to diagnostic understanding, and 15% contributed to a change in treatment. Performance in different protocols varied greatly: lymphoma, pancreas, retroperitoneum, lung, and liver ranked in the top half for both diagnostic and therapeutic efficacy; pelvis, urology, and colon fell in the bottom third. Overall, CT reduced surgery by an estimated 14% and angiography by an estimated 11% in the study population. Availability of CT was also associated over time with significant declines in the frequency of sonographic examinations and of lymphangiography, though not of endoscopic retrograde cholangiopancreatography. Compared with an 18-sec scanner, examinations on a 3-sec unit more frequently contributed to improved diagnostic understanding (p < 0.05) and to increased physician confidence in previously chosen treatment (p < 0.001).
- OSTI ID:
- 5550290
- Journal Information:
- AJR, Am. J. Roentgenol.; (United States), Vol. 141:5
- Country of Publication:
- United States
- Language:
- English
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BIOMEDICAL RADIOGRAPHY
DIAGNOSTIC USES
COMPUTERIZED TOMOGRAPHY
THERAPY
DECISION MAKING
LARGE INTESTINE
LIVER
LUNGS
LYMPHOMAS
PANCREAS
PATIENTS
PELVIS
PERITONEUM
BODY
BODY AREAS
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
ENDOCRINE GLANDS
GASTROINTESTINAL TRACT
GLANDS
INTESTINES
MEDICINE
MEMBRANES
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
RESPIRATORY SYSTEM
SEROUS MEMBRANES
TOMOGRAPHY
USES
550602* - Medicine- External Radiation in Diagnostics- (1980-)