RT Journal Article
SR Electronic
T1 Clinicians' Reasons for Overuse of Skull Radiographs
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 339
OP 342
VO 1
IS 4
A1 Richard O. Cummins
YR 1980
UL http://www.ajnr.org/content/1/4/339.abstract
AB Observations based on a high yield indication list (HYL) revealed that 80% of posttraumatic skull radiographs requested by physicians were not indicated. To investigate this possible overuse of radiography, 15 resident physicians who had used the HYL in a university emergency room were interviewed. The interviews included a questionnaire, case simulations, and discussion of actual head trauma patients. Several general reasons for the overuse were detected: (1) overriding indications to the HYL; (2) basic problem-solving strategies of the physicians (pattern recognition, method of exhaustion, and hypothesis generation and evaluation); (3) the context of the decision-making (patient and family expectations, mentor and peer pressure, malpractice threat, time management concerns); (4) fear of uncertainty; and (5) routines. It was found that overuse of diagnostic radiography was not perverse or irrational, but was produced by a complex mixture of actual expectation of yield from the procedure, personal approaches of the individual physicians, and pressures in the decision-making environment.