Rofo 2017; 189(03): 239-246
DOI: 10.1055/s-0042-118884
Quality/Quality Assurance
© Georg Thieme Verlag KG Stuttgart · New York

Analysis of Radiological Case Presentations and their Impact on Therapy and Treatment Concepts in Internal Medicine

Article in several languages: English | deutsch
Lena-Marie Dendl
1  Department of Radiology, University Hospital Regensburg, Germany
,
Andreas Teufel
2  Department of Internal Medicine 1, University Hospital Regensburg, Germany
,
Stephan Schleder
1  Department of Radiology, University Hospital Regensburg, Germany
,
Janine Rennert
1  Department of Radiology, University Hospital Regensburg, Germany
,
Christian Stroszczynski
1  Department of Radiology, University Hospital Regensburg, Germany
,
Martina Mueller-Schilling
2  Department of Internal Medicine 1, University Hospital Regensburg, Germany
,
Andreas G. Schreyer
1  Department of Radiology, University Hospital Regensburg, Germany
› Author Affiliations
Further Information

Publication History

04 September 2015

01 September 2016

Publication Date:
01 March 2017 (online)

Abstract

Purpose Evaluation of clinical impact regarding diagnostic and therapeutic changes influenced by interdisciplinary radiological case presentations.

Materials and Methods Prospective evaluation of radiological-gastrointestinal clinical case conferences over a 1-year period at a tertiary care center. We documented the preparation (phase 1) and clinical case conference (phase 2) regarding their impact on the radiology report and further diagnostic work-up and therapy.

Results 1067 examinations were evaluated in 69 clinical case conferences including 487 cases. We calculated a mean time of 35.8 minutes per conference with 5.1 minutes per case for preparation. During phase 1, major changes compared to the previous report were found in 1.2 % of cases, and no change was found in 91.4 % of cases. In phase 2 an additional relevant finding was found in 0.6 % of cases, while there was no major change to the reports in 99 % of cases. We recommended further radiological diagnostic workup in 9 % of cases and interventional radiological examination in 2.7 % of cases, while no change was documented in 83.2 %. Further radiological or surgical therapy was recommended in 7 % and 6.8 % of cases, respectively. There was no change in therapy in 78.5 % of cases.

Conclusion The analysis of an interdisciplinary radiological case presentation in internal medicine shows that the case discussion with the radiologist results in a change in patient management in 37.3 % of cases (16.8 % diagnosis, 21.5 % therapy). Overall, interdisciplinary radiological clinical case conferences help to improve the management and quality of patient care. Our data support the broad implementation of radiological clinical case conferences.

Key Points

  • The second opinion obtained during the preparation of a radiological case presentation does not change the written report in most cases.

  • “Talking radiology” in radiological case presentations results in a significant change in patient management in over ⅓ of all cases.

  • In radiological clinical case conferences an experienced radiologist can initiate diagnostic and interventional radiological methods that can be correctly implemented in therapeutic pathways.

  • “Talking radiology” improves the quality of therapy and patient care.

Citation Format

  • Dendl L. M., Teufel A., Schleder S. et al. Analysis of Radiological Case Presentations and their Impact on Therapy and Treatment Concepts in Internal Medicine. Fortschr Röntgenstr 2017; 189: 239 – 246