A thesis submitted in fulfilment of the requirements for the degree
Master of Technology: Diagnostic Radiography
in the Faculty of Health and Wellness Sciences
at the Cape Peninsula University of Technology, 2012 / Complete, accurate and justified radiological examination requests are prerequisite to
radiological exposures. However, global research shows evidence of high numbers of
incomplete and inaccurate requests as well as that up to 77% radiological exposures are
unjustified. Plain lumbar spine and plain skull radiology examinations are reported as being
procedures that generate high dose and a low diagnostic yield. This study was designed to
objectively measure the completeness, accuracy and justification of these two examinations
in an effort to make inferences that will contribute to an improved radiology service. This
research could therefore have positive effects on optimisation of radiation protection in
Zimbabwe.
Methodology
A non participatory prospective descriptive analytical document review of quota sampled
radiological request forms for 200 plain skull and 200 plain lumbar spine examinations was
employed. Data was captured using structured data collection instruments designed and
tested by the researcher for this study. The instrument was designed using the IAEA-HHS4
(2010) minimum prescribed request data as a framework and adding additional form fields
found to be relevant through a review of all identified radiological request template forms in
use at the research site. Data analysis involved central tendency measures and inferential
statistics.
Results: The central tendency demonstrated for the two examinations was that generally
referrers for plain lumbar spine and for plain skull radiology would respectively provide 38.9
+/- 0.6% and 40.2+/-0.5% overall examination request information. This information was
significantly below expectation. There was however no significant difference between the
samples’ means for the two examinations. The tendency demonstrated in patient information
for lumbar spine and skull requests was that generally referrers would respectively provide
48.4 +/- 0.8% and 49.5+/- 0.8% patient information. These values were inclusive of each
other and they were significantly (p=0.00 Sig.) below expectation. There was however no
significant difference between the two examinations’ data. The tendency demonstrated for
examination information was that referrers for the research site would generally provide
29.8+/-0.8% (lumbar) and 32.6+/-0.8% (Skull) examination information. These values were
significantly (p=0.000 Sig.) below expectation and demonstrated a significant difference
between the sample means for the two examinations. With respect to referrer information,
the tendency demonstrated was that generally referrers for plain lumbar spine and for plain
skull examinations would respectively provide 38+/- 1% and 38.5 +/- 0.8% referrer
identification information. These were significantly below expectation (p= 0.000 Sig.) but
there was no significant difference between the samples’ means with respect to referrer
information. With respect to accuracy of request data, it was observed that 5% plain lumbar
spine and 3% plain skull requests were specific in so far as information documented on
request forms could unambiguously identify the area to be imaged. It was also observed that
22.5% (lumbar spine) and 12% (skull) examination requests were indicated and therefore
justified. All requests forms were found to be legible.
Conclusions: Generally, referrers to this research site tend to provide incomplete,
inaccurate and unjustified radiological request data. The observed levels of completeness,
accuracy and justification of requests were generally consistent between the two
examinations relative to expectation. These levels had medico-legal implications and
negative effects on optimisation of radiation protection to patients. Further research to
establish causes of this variance in referral behaviour is recommended. The researcher also
recommends further research to establish whether there is an association between
requested examination and completeness, accuracy and justification of diagnostic radiology
examination requests.
Keywords: Radiation protection, radiological request, complete request, accurate request,
justified request, plain skull imaging, plain lumbar spine imaging.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:cput/oai:localhost:20.500.11838/1552 |
| Date | January 2012 |
| Creators | Sibanda, Lidion |
| Publisher | Cape Peninsula University of Technology |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Rights | http://creativecommons.org/licenses/by-nc-sa/3.0/za/ |
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