Clinical assessment of MR of the brain in nonsurgical inpatients.
PURPOSE: To evaluate the effect of MR imaging of the brain on four domains of patient care: diagnosis, diagnostic workup, therapy, and prognosis. METHODS: Pre- and post-MR written questionnaires and oral interviews were administered to the referring clinicians of 103 medical and neurologic inpatients at a tertiary care institution. Additional information was obtained from radiologic reports and records. RESULTS: The study population had a diverse array of signs and symptoms and of presumptive clinical diagnoses, reflecting the breadth of disease seen at our institution. The vast majority of physicians (89%) reported that MR imaging added significant diagnostic information, playing an important role in guiding diagnostic workup (24%), planning treatment (34%), and estimating prognosis (47%). MR imaging was significantly more likely to decrease than to increase confidence in the presumptive clinical diagnosis. Thus, MR imaging may be most useful in the setting of diagnostic uncertainty. CONCLUSION: Our results show that MR imaging of the brain has important effects on each of the four domains of care for medical inpatients.
Hirsch, JA; Langlotz, CP; Lee, J; Tanio, CP; Grossman, RI; Schulman, KA
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