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
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The second opinion obtained during the preparation of a radiological case presentation
does not change the written report in most cases.
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“Talking radiology” in radiological case presentations results in a significant change
in patient management in over ⅓ of all cases.
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In radiological clinical case conferences an experienced radiologist can initiate
diagnostic and interventional radiological methods that can be correctly implemented
in therapeutic pathways.
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“Talking radiology” improves the quality of therapy and patient care.
Citation Format
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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
Key words
decision analysis - cost-effectiveness - health policy and practice
