Rational Use of Diagnostic Radiology

The escalating number of radiodiagnostic investigations has, as a consequence, an increase in medical irradiation of patients and of cost of radiological services. Radiologists in USA and UK have since early 1970 questioned the efficacy of various radiological investigations and produced substantial evidence that more rational approaches are necessary. WHO initiated, in 1977, a programme in this direction which has issued four technical reports which give practical recommendations on how to rationalise the use of radiological examinations. Three main directions are considered: (1) Abandonment of routine radiological examinations, as procedures with no clinical or epidemiologic significance and which represent a waste of resources and patient dose. (2) Patient selection for various radiological investigations based on clinical criteria (high, intermediate, low yield). Selected patients have an increased prevalence of the given disease and the predictive value of radiological investigation is much higher. (3) Use of diagnostic algorithms with higher cost/efficiency and risk/benefit ratios, improving the outcome of radiological examinations.