How effective is the use of medical imaging in everyday clinical practice?
The results of a study by Augsburg 伟德国际_伟德国际1946$娱乐app游戏 伟德国际_伟德国际1946$娱乐app游戏icine have been published in the renowned journal JAMA.
Similar to a digital route planner, specific programmes support doctors in their everyday clinical work by selecting diagnostic and therapeutic procedures. The MIDAS study, led by Augsburg 伟德国际_伟德国际1946$娱乐app游戏 伟德国际_伟德国际1946$娱乐app游戏icine, examined the effectiveness of such clinical decision-making aids for medical imaging in a multicentre, randomised study. The results have now been published in JAMA, one of the five most important medical journals worldwide. 伟德国际_伟德国际1946$娱乐app游戏ical imaging is an essential component of modern medicine. Due to advanced technologies like computerised tomography (CT) and magnetic resonance imaging (MRI), diseases can be detected earlier and more accurately diagnosed. At the same time, the increased use of these procedures leads to an exponential increase in examinations, not all of which are medically necessary. This can lead to unnecessary exposure to radiation, longer wait times, higher costs, and additional burdens on medical personnel. The MIDAS study was conducted with the support of Federal Joint Committee’s Innovation Fund at 26 departments of the participating university hospitals. All departments were part of a control group in the first phase of the project, in which the decision support system was implemented but gave no feedback to doctors. After 16 months, the departments were divided into an intervention and control group. Only the intervention group received feedback to their examination requests and recommendations for alternative diagnostic procedures. The study showed that such a system could be integrated into the clinical practice of university hospitals. However, there were no relevant differences found in the number of inappropriate imaging requests, in costs or radiation exposure. This could be because university hospitals employ highly qualified and specialist doctors who already possess a deep understanding of the indications for imaging procedures. This is also reflected in the very high number of requests that conformed with the guidelines in the control group.
Clinical decision support systems (CDSS) are designed to support doctors in selecting appropriate procedures or therapeutic approaches by providing real-time feedback. Despite promising approaches, their acceptance in clinical practice remains low. The MIDAS study therefore investigated whether such a system specially designed for requesting imaging procedures could be used effectively at the 伟德国际_伟德国际1946$娱乐app游戏 Hospital Augsburg. In the study, a traffic-light system indicated to the doctor whether the selected imaging procedure matched the respective clinical profile.
Prof Dr Thomas Kr?ncke, initiator and coordinator of the study at the chair for diagnostic and interventional radiology and at the clinic of the same name at the 伟德国际_伟德国际1946$娱乐app游戏 Hospital Augsburg, emphasised: “I am delighted about the successful completion of the MIDAS study, along with my partners at the 伟德国际_伟德国际1946$娱乐app游戏 Hospitals Schleswig-Holstein, Kiel, Lübeck, Mainz, and Rotterdam. The publication in JAMA shows that as a network we have addressed a highly relevant topic.”MIDAS study design
The study ran for two and a half years at the 伟德国际_伟德国际1946$娱乐app游戏 Hospitals in Augsburg, Kiel, Lübeck, and Mainz. Data analysis was carried out in cooperation with the Erasmus 伟德国际_伟德国际1946$娱乐app游戏ical Center in Rotterdam. The aim was to determine whether the proportion of imaging requests that did not conform with the guidelines could be reduced by using the CDSS.Results
Nevertheless, the decision support system could be effectively implemented in other medical facilities such as small hospitals, healthcare facilities, or doctors’ practices to enable targeted use of imaging procedures.
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