Authors
Directorate-General for Energy, European Commission, Brkljačić, B, Karoussou-Schreiner, A, Sosna, J, Foley, S, Bly, R, Brady, A, Ebdon-Jackson, S, Demuth, F, Singer, C, Saban, M, Bergovoy Yellin, L, Hierath, M, Szucsich, M
- Catalogue number
- MJ-XA-24-002-EN-N
- Citation
- European Commission: Directorate-General for Energy, Brkljačić, B., Karoussou-Schreiner, A., Sosna, J., Foley, S. et al., European co-ordinated action on improving justification of computed tomography – Results and recommendations from a first-time multi-national study on CT justification in the EU, Publications Office of the European Union, 2024, https://data.europa.eu/doi/10.2833/80267
- DOI
- https://data.europa.eu/doi/10.2833/80267
- ISBN
- 978-92-68-20270-8
- ISSN
- 2315-2826
- Pages
- 229
- Published in
- Belgium
- Themes
- Medical and biological research
Table of Contents
- Table of Contents 5
- List of Tables 7
- List of Figures 12
- List of Abbreviations 14
- Disclaimer 17
- PART 1 18
- Abstract 18
- Résumé 18
- Acknowledgements 19
- Executive Summary 19
- Findings 23
- Conclusions 24
- Recommendations 24
- Synthèse 25
- Résultats 30
- Conclusions 30
- Recommandations 31
- 1. Introduction 32
- 2. Literature Review and Survey on Status of CT Justification in Europe 32
- 3. Audit Methodology and Tools 33
- 4. Workshop 34
- 5. Results of the Pilot Audits 34
- 5.4.1 Summary of the Results of the Survey of Participating Centres 38
- 5.6.1 Belgium 62
- 5.6.2 Denmark 81
- 5.6.3 Estonia 98
- 5.6.4 Finland 115
- 5.6.5 Greece 133
- 5.6.6 Hungary 152
- 5.6.7 Slovenia 170
- 5.8.1 Explanatory elements for the low number of paediatric CTs 185
- 5.8.2 Difference in justification rate between general practitioners (GPs) and (other) specialist doctors 185
- 5.8.3 Difference in appropriateness rate between body regions 186
- 5.8.4 Understanding the differences between public/private facilities 186
- 5.8.5 Understanding the overall correlation between justification efforts and audit results 186
- 5.8.6 Lessons learned/recommendations for countries wishing to carry out audits 187
- 5.8.7 Impact of MRI availability 188
- 5.8.8. Most appropriate examination if CT was inappropriate (if data available) 188
- 5.8.9 Correlation between quality assurance and quality of results 189
- 5.8.10 Correlation between referral guideline availability and quality of results 189
- 5.8.11 Difference in appropriateness rates between inpatient and outpatient settings 189
- 5.8.12 COVID-19 situation at the time of referral collection and related impact 189
- 5.8.13 Key findings 190
- 5.8.14 Suggestions to improve the justification of CT examinations 191
- References 192
- Annex 1: EU-JUST-CT Consortium, Advisory Group, Steering Group, pilot country NCA/NRS, statisticians 193
- Annex 2: Final Audit Methodology and Tools 196
- Table of Contents 198
- 1. Introduction 199
- 2. Survey on the implementation of the process of justification 200
- 3. Imaging referral guidelines – The ESR iGuide tool 200
- 4. Stakeholder Involvement. Roles and responsibilities 200
- 5. Referral Sampling 202
- 6. Data collected 203
- 7. Limitations of the methodology 203
- 8. References 203
- Annexes 205
- PART 2: Guidance Document to Assist Radiology Departments in Improving Justification 208
- Disclaimer 210
- Table of Contents 211
- List of Abbreviations 212
- 2. 212
- 1. Introduction 213
- 2. European Basic Safety Standards Directive and National Regulations etc – legal requirements 214
- 2.4.1 The referrer 216
- 2.4.2 The practitioner 216
- 2.4.3 The patient 217
- 3. Education and Training 217
- 4. How the Justification Process is Carried Out in Practice 217
- 5. Practical Tools to Facilitate and Undertake the Justification Process 218
- 6. Practical Tools to Assess the Justification Process 220
- 7. Challenges for Imaging Departments 220
- 8. The Regulator and the Imaging Department 222
- 9. Conclusions 223
- 10. References 224
- 11. Appendix 1 227