Patient questionnaires improve rads’ reads for abdominal pain

Abdominal radiologists make more complete and precise diagnostic reads, and are more confident in their diagnoses, when they’re armed at the reading station with clinical information supplied by patients via questionnaire, according to a study published online June 24 in Abdominal Radiology.

Ankur Doshi, MD, Andrew Rosenkrantz, MD, and colleagues at NYU Langone Medical Center in New York retrospectively reviewed 100 outpatient CT imaging exams spurred by patients’ complaints of abdominal pain, comparing the specificity of pain locale between the order requisition and a patient questionnaire.

The questionnaire obtained info directly from patients on relevant clinical history as well as on characteristics of the pain itself.

Two radiologists—an abdominal fellow (Reader 1) and an abdominal subspecialist (Reader 2)—interpreted the scans twice each at six-week intervals: once with just the requisition and once with that plus the patient questionnaire.

The team found that, in 30 percent of the cases, the questionnaire provided a more specific location for pain. Among these, the pain was localized to a specific quadrant in 40 percent.

Further, the authors report:

• With access to the questionnaire, both readers identified additional causes for pain not identified in the requisition-only read (Reader 1, 8.6 percent [7 of 81]; Reader 2, 5.3 percent [4 of 75]).
• Additional identified causes of pain included diverticulitis, cystitis, peritoneal implants, umbilical hernia, gastritis and other conditions.
• Confidence in interpretation was significantly greater using the questionnaire for both readers.

“Patient questionnaires provide additional relevant clinical history, increased diagnostic yield, and improve radiologists’ confidence,” the authors conclude. “Radiology practices are encouraged to implement questionnaires and make these readily available to radiologists at the time of interpretation.”