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. 2021 Apr;65(1):66-75.

The association between guideline adherent radiographic imaging by chiropractic students and the diagnostic yield of clinically significant findings

Shangavi Parthipan  1 , Chris Bowles  2 , Katie de Luca  2 , Hazel Jenkins  2
Affiliations

The association between guideline adherent radiographic imaging by chiropractic students and the diagnostic yield of clinically significant findings

Shangavi Parthipan et al. J Can Chiropr Assoc. 2021 Apr.

Abstract
in English, French

Background: Radiographic guidelines aim to increase the diagnostic yield of clinically relevant imaging findings whilst minimising risk. This study assessed the appropriateness of radiographic referrals made by student chiropractors and explored the association between guideline appropriate imaging and clinically significant radiographic findings.

Methods: Radiographic referral and report findings (n=437) from 2018 were extracted from Macquarie University chiropractic clinics. Appropriateness of radiographic referrals was assessed according to current radiographic guidelines. Radiographic findings were assessed for clinical significance. The association between guideline appropriate radiographic referral and clinically significant radiographic findings was assessed using logistic regression analysis and odds ratios were estimated.

Results: The proportion of guideline appropriate imaging was 55.8% (95%CI: 51.2-60.4). An association between guideline appropriate radiographs and clinically significant findings was found (OR: 2.2; 95%CI: 1.3-4.1).

Conclusions: Approximately half of all radiographic referrals made by chiropractic students were guideline concordant. Guideline appropriate imaging was associated with an increase in clinically significant radiographic findings.

Contexte: Les lignes directrices relatives aux demandes d’examens radiographiques visent à accroître le rendement diagnostique des résultats des examens d’imagerie cliniquement pertinents tout en minimisant le risque. La présente étude a consisté à évaluer la pertinence des examens radiographiques demandés par des étudiants en chiropratique et à examiner le lien entre la pertinence des demandes d’examens d’imagerie et les résultats des examens radiographiques cliniquement pertinents.

Méthodologie: Des demandes d’examens radiographiques et des rapports d’examens (n = 437) en 2018 ont été extraits de dossiers de la clinique de chiropratique de la Macquarie University. La pertinence des demandes d’examens radiographiques a été évaluée en fonction des lignes directrices relatives aux demandes d’examens radiographiques en vigueur. La pertinence des résultats des examens radiographiques a été évaluée. On a examiné le lien entre les demandes d’examen radiographique conformes aux lignes directrices et les résultats d’examens radiographiques cliniquement importants à l’aide d’une méthode d’analyse par régression logistique et on a estimé les risques relatifs.

Résultats: La proportion de demandes d’examen d’imagerie qui étaient conformes aux lignes directrices s’est élevée à 55,8 % (IC à 95 % : 51,2–60,4). On a établi un lien entre les demandes d’examens radiographiques conformes aux lignes directrices et les résultats cliniquement pertinents (RR : 2,2; IC à 95 % : 1,3–4,1).

Conclusions: Environ la moitié de toutes les demandes d’examens radiographiques provenant d’étudiants en chiropratique étaient conformes aux lignes directrices. Les demandes d’examens d’imagerie conformes aux lignes ont été associées à une hausse de résultats d’examens cliniquement pertinents.

Keywords: appropriate use; chiropractic; diagnostic yield; guidelines; radiographs.

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Conflict of interest statement

The authors have no disclaimers, competing interests, or sources of support or funding to report in the preparation of this manuscript.

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