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Use reduced radiation dose CT in suspected kidney stone patients, suggests study

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Reduced radiation dose computed tomography (CT) should be used when CT is needed for suspected kidney stone, according to a study published in the Annals of emergency medicine.

A kidney stone is one of the major kidney disorders which needs timely detection and intervention. For suspected kidney stones, CT scan is frequently as a diagnostic tool.  CT is accurate but exposes patients to ionizing radiation and has not been shown to alter either interventional approaches or hospital admission rates.

A multiorganizational transdisciplinary collaboration of Christopher L. Moore, Yale associate professor and chief of the section of emergency ultrasound in the department of emergency medicine, with a group of multidisciplinary researchers conducted a conducted a systematic review of the scientific literature seeking an evidence-based, multispecialty consensus on optimal imaging across different clinical scenarios in patients with suspected renal colic in the acute setting.

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In conjunction with the American College of Emergency Physicians (ACEP) Emergency Quality Network, the group formed a 9-member panel with 3 physician representatives each from ACEP, the American College of Radiology, and the American Urology Association. A systematic literature review was used as the basis for a 3-step modified Delphi process to seek consensus on optimal imaging in 29 specific clinical scenarios.

Key Observation 

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  • From an initial search yielding 6,337 records, there were 232 relevant articles of acceptable evidence quality to guide the literature summary.
  • At the completion of the Delphi process consensus, out of the 29 scenarios agreement was rated as perfect in 15, excellent in 8, good in 3, and moderate in 3.
  • There were no scenarios in which at least moderate consensus was not reached.
  • CT was recommended in 7 scenarios, with ultrasonography in 9 and no further imaging needed in 12.

“Evidence and multispecialty consensus support ultrasonography or no further imaging in specific clinical scenarios, with reduced-radiation-dose CT to be used when CT is needed for patients with suspected renal colic.” concluded the authors.

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For reference, follow the link

DOI: https://doi.org/10.1016/j.annemergmed.2019.04.021




Source: self

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