The NATAVUS Study Necessity And Technical Adequacy of Vascular Ultrasound Scans

Rebecca Jack (2010). The NATAVUS Study Necessity And Technical Adequacy of Vascular Ultrasound Scans MPhil Thesis, School of Medicine, The University of Queensland.

       
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Author Rebecca Jack
Thesis Title The NATAVUS Study Necessity And Technical Adequacy of Vascular Ultrasound Scans
School, Centre or Institute School of Medicine
Institution The University of Queensland
Publication date 2010-01
Thesis type MPhil Thesis
Supervisor Associate Professor Philip Walker
Dr Douglas Cavaye
Total pages 54
Total colour pages 12
Total black and white pages 42
Subjects 11 Medical and Health Sciences
Abstract/Summary Ultrasound has become a widely available imaging modality for the investigation of patients with a variety of clinical conditions. Concerns have been raised by clinicians and government alike that a sizeable proportion of this imaging may be unnecessary, inappropriate or of inadequate quality for patient management. This study aims to prospectively evaluate the opinions of treating vascular clinicians as to whether the vascular ultrasound imaging studies that patients bring with them when initially referred are necessary, and technically adequate to permit clinical decision-making for the patient’s management. Vascular clinicians Australia-wide were invited to participate in the study in April 2003. They were asked to recruit their next 50 consecutive new patients, eligible to be enrolled in the study, who presented with ultrasound scans organized by their referring doctor. The clinicians were asked to fill out a two-page proforma detailing the diagnosis, if known, and their opinion regarding the study and report, whether they required further information, and what investigations they would have ordered if seeing the patient for the first time, in a primary setting. 17 vascular clinicians Australia-wide agreed to participate in the study and to recruit their next 50 patients referred to them with vascular ultrasound imaging performed prior to specialist consultation. 473 Proformas were returned for analysis. Of all studies performed, 19 percent were judged unnecessary. Studies that were considered necessary however, were, in some cases, technically inaccurately or inadequately reported in 27 percent of cases, and 67 percent of these studies were then repeated. The NATAVUS Study has demonstrated that a significant percentage of ultrasound imaging performed by referring clinicians to vascular specialists is unnecessary, and that necessary imaging does not, in a large percentage of cases, provide accurate and adequate data to allow for specialist clinical decision-making. The data from this study has the potential to develop guidelines for appropriate use of vascular ultrasound imaging for various vascular conditions. If the results of this study were to be duplicated in a larger study, development and adoption of such guidelines would have the potential to generate significant cost savings to the health system by the elimination of some unnecessary testing. This is of particular relevance with Australia’s ageing population.
Keyword natavus, necessity, technical adequacy, vascular ultrasound
Additional Notes 17,19,25,30,31,34,35,37,39,40,41,42.

 
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Created: Sun, 23 May 2010, 18:47:45 EST by Dr Rebecca Jack on behalf of Library - Information Access Service