{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:55:40Z","timestamp":1781499340090,"version":"3.54.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"German Innovation Fund","award":["01VSF18008"],"award-info":[{"award-number":["01VSF18008"]}]},{"name":"German Innovation Fund","award":["01VSF18008"],"award-info":[{"award-number":["01VSF18008"]}]},{"name":"German Innovation Fund","award":["01VSF18008"],"award-info":[{"award-number":["01VSF18008"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Abdom Radiol"],"DOI":"10.1007\/s00261-025-05300-4","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T13:38:33Z","timestamp":1766151513000},"page":"3690-3696","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inappropriate imaging requests in abdominal imaging: observations from the MIDAS study, a multicenter randomized controlled trial in Germany"],"prefix":"10.1007","volume":"51","author":[{"given":"Stijntje Willemijn","family":"Dijk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Mommersteeg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne","family":"Steltenpool","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Wollny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"van der Voorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zita","family":"van Os","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kroencke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"5300_CR1","first-page":"2277","volume":"357","author":"DJ Brenner","year":"2007","unstructured":"Brenner DJ, Hall EJ. Computed tomography\u2014an increasing source of radiation exposure. New England journal of medicine. Mass Medical Soc; 2007;357:2277\u201384.","journal-title":"New England journal of medicine. Mass Medical Soc"},{"key":"5300_CR2","doi-asserted-by":"publisher","first-page":"e3502","DOI":"10.1136\/bmj.e3502","volume":"344","author":"R Moynihan","year":"2012","unstructured":"Moynihan R, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy. BMJ. 2012;344:e3502\u2013e3502. https:\/\/doi.org\/10.1136\/bmj.e3502","journal-title":"BMJ"},{"key":"5300_CR3","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1056\/NEJMp1507703","volume":"373","author":"DJ Durand","year":"2015","unstructured":"Durand DJ, Lewin JS, Berkowitz SA. Medical-Imaging Stewardship in the Accountable Care Era. New England Journal of Medicine. 2015;373:1691\u20133. https:\/\/doi.org\/10.1056\/NEJMp1507703","journal-title":"New England Journal of Medicine"},{"key":"5300_CR4","doi-asserted-by":"publisher","first-page":"2168","DOI":"10.1007\/s00330-023-10244-8","volume":"34","author":"SW Dijk","year":"2023","unstructured":"Dijk SW, Hunink MGM. Nurturing health, resilience, and well-being among medical imaging professionals: creating resilient organizations for sustainable healthcare. Eur Radiol. 2023;34:2168\u201370. https:\/\/doi.org\/10.1007\/s00330-023-10244-8","journal-title":"Eur Radiol"},{"key":"5300_CR5","doi-asserted-by":"publisher","unstructured":"Protheroe E. Overuse of Medical Imaging in Low-Middle Income Countries: A Scoping Review. Journal of Global Radiology. 2024;10. https:\/\/doi.org\/10.7191\/jgr.906","DOI":"10.7191\/jgr.906"},{"key":"5300_CR6","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1067\/j.cpradiol.2020.11.004","volume":"50","author":"MZ Francisco","year":"2021","unstructured":"Francisco MZ, Altmayer S, Verma N, Watte G, Brandao M de C, Barros MC, et al. Appropriateness of Computed Tomography and Ultrasound for Abdominal Complaints in the Emergency Department. Curr Probl Diagn Radiol. 2021;50:799\u2013802. https:\/\/doi.org\/10.1067\/j.cpradiol.2020.11.004","journal-title":"Curr Probl Diagn Radiol"},{"key":"5300_CR7","first-page":"1","volume":"10","author":"European Society of Radiology","year":"2019","unstructured":"European Society of Radiology. Methodology for ESR iGuide content. Insights Imaging. Springer; 2019;10:1\u20135.","journal-title":"Insights Imaging. Springer"},{"key":"5300_CR8","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.jacr.2015.08.026","volume":"13","author":"AY Sheng","year":"2016","unstructured":"Sheng AY, Castro A, Lewiss RE. Awareness, utilization, and education of the ACR appropriateness criteria: a review and future directions. Journal of the American College of Radiology. Elsevier; 2016;13:131\u20136.","journal-title":"Journal of the American College of Radiology. Elsevier"},{"key":"5300_CR9","doi-asserted-by":"publisher","first-page":"e43","DOI":"10.15557\/JoU.2020.0008","volume":"20","author":"C Caraiani","year":"2020","unstructured":"Caraiani C, Yi D, Petresc B, Dietrich C. Indications for abdominal imaging: When and what to choose? J Ultrason. 2020;20:e43.","journal-title":"J Ultrason"},{"key":"5300_CR10","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/1865-1380-4-19","volume":"4","author":"AS Raja","year":"2011","unstructured":"Raja AS, Mortele KJ, Hanson R, Sodickson AD, Zane R, Khorasani R. Abdominal imaging utilization in the emergency department: trends over two decades. Int J Emerg Med. 2011;4:19. https:\/\/doi.org\/10.1186\/1865-1380-4-19","journal-title":"Int J Emerg Med"},{"key":"5300_CR11","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1111\/acem.12625","volume":"22","author":"HK Kanzaria","year":"2015","unstructured":"Kanzaria HK, Hoffman JR, Probst MA, Caloyeras JP, Berry SH, Brook RH. Emergency Physician Perceptions of Medically Unnecessary Advanced Diagnostic Imaging. Academic Emergency Medicine. 2015;22:390\u20138. https:\/\/doi.org\/10.1111\/acem.12625","journal-title":"Academic Emergency Medicine"},{"key":"5300_CR12","doi-asserted-by":"publisher","first-page":"187","DOI":"10.5114\/pjr.2022.115126","volume":"87","author":"S Salerno","year":"2022","unstructured":"Salerno S, Terranova MC, Anzelmo MT, Vinci A, Vernuccio F, Collura G, et al. Are we overusing abdominal computed tomography scans in young patients referred in an emergency for acute abdominal pain? Pol J Radiol. 2022;87:187\u201393. https:\/\/doi.org\/10.5114\/pjr.2022.115126","journal-title":"Pol J Radiol"},{"key":"5300_CR13","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/j.jamcollsurg.2011.07.008","volume":"213","author":"J Benarroch-Gampel","year":"2011","unstructured":"Benarroch-Gampel J, Boyd CA, Sheffield KM, Townsend CM, Riall TS. Overuse of CT in Patients with Complicated Gallstone Disease. J Am Coll Surg. 2011;213:524\u201330. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2011.07.008","journal-title":"J Am Coll Surg"},{"key":"5300_CR14","doi-asserted-by":"publisher","first-page":"S955","DOI":"10.14309\/00000434-201510001-02304","volume":"110","author":"D Patel","year":"2015","unstructured":"Patel D, Vunnam S, Choksi TT, Gevorgyan D, Sheth V, Kumar N, et al. Inappropriate Use of Imaging as a First Diagnostic Tool in Severe Active Lower Gastrointestinal Bleeding (LGIB) Predicted Negative Outcomes in Key Parameters: An Experience in Two Community Hospitals. American Journal of Gastroenterology. 2015;110:S955\u20136.","journal-title":"American Journal of Gastroenterology"},{"key":"5300_CR15","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12913-019-3870-2","volume":"19","author":"CL Bertin","year":"2019","unstructured":"Bertin CL, Ponthus S, Vivekanantham H, Poletti P-A, Kherad O, Rutschmann OT. Overuse of plain abdominal radiography in emergency departments: a retrospective cohort study. BMC Health Serv Res. 2019;19:36. https:\/\/doi.org\/10.1186\/s12913-019-3870-2","journal-title":"BMC Health Serv Res"},{"key":"5300_CR16","doi-asserted-by":"publisher","first-page":"107384","DOI":"10.1016\/j.cct.2023.107384","volume":"135","author":"SW Dijk","year":"2023","unstructured":"Dijk SW, Kroencke T, Wollny C, Barkhausen J, Jansen O, Halfmann MC, et al. Medical Imaging Decision And Support (MIDAS): Study protocol for a multi-centre cluster randomized trial evaluating the ESR iGuide. Contemp Clin Trials. Elsevier; 2023;135:107384.","journal-title":"Contemp Clin Trials. Elsevier"},{"key":"5300_CR17","doi-asserted-by":"crossref","unstructured":"Dijk SW, Wollny C, Barkhausen J, Jansen O, Mildenberger P, Halfmann MC, et al. Evaluation of a Clinical Decision Support System for Imaging Requests: A Cluster Randomized Clinical Trial. JAMA. 2025;","DOI":"10.1001\/jama.2024.27853"},{"key":"5300_CR18","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-025-02027-0","author":"T Kroencke","year":"2025","unstructured":"Kroencke T, Dijk SW, Halfmann MC, Wollny C, Barkhausen J, Janssen O, et al. Challenges and Insights from implementing Clinical Decision Support Systems for Radiologic Imaging: experience from the MIDAS trial. Insights Imaging [Internet]. 2025 [cited 2025 Jul 2]; https:\/\/doi.org\/https:\/\/doi.org\/10.1186\/s13244-025-02027-0","journal-title":"Insights Imaging [Internet]"},{"key":"5300_CR19","unstructured":"Dijk S. Decision-making in medical research, practice and education. Rotterdam: Erasmus University Rotterdam [Doctoral Thesis]; 2025."},{"issue":"3","key":"5300_CR20","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1001\/jama.2025.5285","volume":"334","author":"SW Dijk","year":"2025","unstructured":"Dijk SW, Kroencke T. Clinical Decision Support System for Imaging Requests\u2014Reply. JAMA. 2025;334(3):277. https:\/\/doi.org\/10.1001\/jama.2025.5285","journal-title":"JAMA"},{"key":"5300_CR21","unstructured":"RadiologyInfo.org. Effective radiation dose in adults. https:\/\/www.radiologyinfo.org\/en\/info\/safety-xray."},{"key":"5300_CR22","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1007\/s00508-019-01557-0","volume":"132","author":"D Wachabauer","year":"2020","unstructured":"Wachabauer D, Mathis-Edenhofer S, Moshammer H. Medical radiation exposure from radiological and interventional procedures in Austria. Wien Klin Wochenschr. Springer; 2020;132:563\u201371.","journal-title":"Wien Klin Wochenschr. Springer"},{"key":"5300_CR23","doi-asserted-by":"crossref","unstructured":"Mahesh M, Ansari AJ, Mettle FA. Erratum for: Patient Exposure from Radiologic and Nuclear Medicine Procedures in the United States and Worldwide: 2009\u20132018. Radiology. Radiological Society of North America; 2023;307:e239013.","DOI":"10.1148\/radiol.239013"},{"key":"5300_CR24","unstructured":"Ward P. Audit shows 25% of abdominal x-ray requests are inappropriate. https:\/\/www.auntminnieeurope.com\/subspecialties\/gastrointestinal-radiology\/abdominal-imaging\/article\/15652415\/audit-shows-25-of-abdominal-x-ray-requests-are-inappropriate. 2018;"},{"key":"5300_CR25","doi-asserted-by":"crossref","unstructured":"Dijk S, Kroencke T, Wollny C, Hunink M. Sex differences in inappropriate imaging requests: Insights from the Medical Imaging Decision And Support (MIDAS) study. Eur Radiol. 2025;","DOI":"10.1007\/s00330-025-12088-w"},{"key":"5300_CR26","doi-asserted-by":"publisher","first-page":"4218","DOI":"10.1007\/s00330-021-08479-4","volume":"32","author":"M Saban","year":"2022","unstructured":"Saban M, Sosna J, Singer C, Vaknin S, Myers V, Shaham D, et al. Clinical decision support system recommendations: how often do radiologists and clinicians accept them? Eur Radiol. Springer; 2022;32:4218\u201324.","journal-title":"Eur Radiol. Springer"},{"key":"5300_CR27","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1001\/jamainternmed.2015.5987","volume":"175","author":"R Gonzales","year":"2015","unstructured":"Gonzales R, Cattamanchi A. Changing Clinician Behavior When Less Is More. JAMA Intern Med. 2015;175:1921. https:\/\/doi.org\/10.1001\/jamainternmed.2015.5987","journal-title":"JAMA Intern Med"},{"key":"5300_CR28","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.jacr.2014.01.019","volume":"11","author":"M Horn\u00fd","year":"2014","unstructured":"Horn\u00fd M, Burgess JF, Horwitt J, Cohen AB. Advanced Diagnostic Imaging in Privately Insured Patients: Recent Trends in Utilization and Payments. Journal of the American College of Radiology. 2014;11:692\u20137. https:\/\/doi.org\/10.1016\/j.jacr.2014.01.019","journal-title":"Journal of the American College of Radiology"},{"key":"5300_CR29","first-page":"141","volume-title":"Physician thoughts on unnecessary noninvasive imaging and decision support software: A qualitative study. Clin Ethics","author":"DE Winchester","year":"2020","unstructured":"Winchester DE, Freytes IM, Schmitzberger M, Findley K, Beyth RJ. Physician thoughts on unnecessary noninvasive imaging and decision support software: A qualitative study. Clin Ethics. SAGE Publications Sage UK: London, England; 2020;15:141\u20137."},{"key":"5300_CR30","doi-asserted-by":"crossref","unstructured":"Gabelloni M, Di Nasso M, Morganti R, Faggioni L, Masi G, Falcone A, et al. Application of the ESR iGuide clinical decision support system to the imaging pathway of patients with hepatocellular carcinoma and cholangiocarcinoma: preliminary findings. Radiol Med. Springer; 2020;125:531\u20137.","DOI":"10.1007\/s11547-020-01142-w"}],"container-title":["Abdominal Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00261-025-05300-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00261-025-05300-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00261-025-05300-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:43:38Z","timestamp":1781498618000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00261-025-05300-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":30,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["5300"],"URL":"https:\/\/doi.org\/10.1007\/s00261-025-05300-4","relation":{},"ISSN":["2366-0058"],"issn-type":[{"value":"2366-0058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]},"assertion":[{"value":"26 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare the following financial interests\/personal relationships which may be considered as potential competing interests: Dr. Dijk receives (or received in the past 36 months) research funding from the Gordon and Betty Moore Foundation. Dr.rer.nat. Wollny has no conflicts of interest to report. Dr. Mommersteeg has no conflicts of interest to report. Dr. Steltenpool has no conflicts of interest to report. Dr. van Os has no conflicts of interest to report. Dr. van der Voorn has no conflicts of interest to report. Dr. Kroencke receives (or received within the past 36 months) research funding outside the submitted work from The Bavarian Centre for Cancer Research, the national Network University Medicine (NUM) and Siemens Healthineers, has received honoraria for educational symposia from SIRTEX Medical, Boston Scientific and Abbott Medical GmbH and re-imbursements of expenses related to his work in the executive committee and congressional events of the Cardiovascular and Interventional Radiological Society of Europe.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}