{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:04:02Z","timestamp":1773932642553,"version":"3.50.1"},"reference-count":20,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dan Med J"],"abstract":"<jats:p>INTRODUCTION. The number of CTs performed worldwide has increased significantly over the past 20 years, with abdominal CTs being the most common. This trend has raised concerns about patient safety due to lifetime cumulative exposure to cancer-associated ionising radiation. The aim of this study was to evaluate the clinical justification for performing acute abdominal CTs in Danish patients admitted to a surgical department.\n\nMETHODS. This quality assurance study was conducted as a clinical audit at the North Denmark Regional Hospital. A total of 200 patients who had undergone acute abdominal CTs during a four-year period were randomly selected for review. Two independent audit teams, comprising radiologists and surgeons, assessed clinical justification through a consensus review of medical records.\n\nRESULTS. The audit revealed that 36% of the acute abdominal CTs were deemed clinically unjustified. Two-thirds of these CTs were performed for an established or suspected malignancy.\n\nCONCLUSIONS. One-third of the acute abdominal CTs were considered unjustified, primarily due to inconsistent or inadequate adherence to regional and national guidelines. Improved physician education and clearer diagnostic imaging guidelines for conditions with diagnostic uncertainty are recommended.\n\nFUNDING. None.\n\nTRIAL REGISTRATION. Not relevant.<\/jats:p>","DOI":"10.61409\/a07250557","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:53:09Z","timestamp":1771923189000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["An audit of referrals for acute abdominal CT scans"],"prefix":"10.61409","author":[{"given":"Sara Louise","family":"Olesen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida Hylander","family":"Frederiksen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Hessellund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Derek Christian","family":"Leutscher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrine","family":"Holte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"40208","published-online":{"date-parts":[[2026,2]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Shao Y, Tsai K, Kim S, et al. Exposure to tomographic scans and cancer risks. JNCI Cancer Spectr. 2020;4(1):pkz072. https:\/\/doi.org\/10.1093\/jncics\/pkz072","DOI":"10.1093\/jncics\/pkz072"},{"key":"ref1","unstructured":"Eurostat. Medical technologies - examinations by medical imaging techniques (CT, MRI and PET). https:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/hlth_co_exam\/default\/table?lang=en (15 Mar 2024)"},{"key":"ref2","unstructured":"Danish Health Authority. Udviklingen i brug af r\u00f8ntgenunders\u00f8gelser i Danmark [Trends in the use of X-ray imaging in Denmark]. Danish Health Authority, 2015. www.sst.dk\/-\/media\/Udgivelser\/2015\/Udviklingen-i-brug-af-r\u00f8ntgenunders\u00f8gelser-i-Danmark.ashx (2 Mar 2025)"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"de Burlet KJ, MacKay M, Larsen P, Dennett ER. Appropriateness of CT scans for patients with non-traumatic acute abdominal pain. Br J Radiol. 2018;91(1088):20180158. https:\/\/doi.org\/10.1259\/bjr.20180158","DOI":"10.1259\/bjr.20180158"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Lehtim\u00e4ki T, Juvonen P, Valtonen H, et al. Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial. Eur Radiol. 2013;23(9):2538-2545. https:\/\/doi.org\/10.1007\/s00330-013-2848-4","DOI":"10.1007\/s00330-013-2848-4"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Bolus NE. NCRP Report 160 and what it means for medical imaging and nuclear medicine. J Nucl Med Technol. 2013;41(4):255-260. https:\/\/doi.org\/10.2967\/jnmt.113.128728","DOI":"10.2967\/jnmt.113.128728"},{"key":"ref6","unstructured":"Danish Health Authority. Patientdosimetri ved CT-skanninger af voksne [Patient dosimetry in adult CT scans]. Sundhedsstyrelsen, 2022. www.sst.dk\/-\/media\/Udgivelser\/2022\/Patientdosimetri\/Vejledning-om-patientdosimetri-ved-CT-skanninger-af-voksne_udgivelse-maj-2022.ashx?sc_lang=da&hash=32F030A8801369CCA2780CD52A2DAFFF (2 Mar 2025)"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Lin EC. Radiation risk from medical imaging. Mayo Clin Proc. 2010;85(12):1142-1146. https:\/\/doi.org\/10.4065\/mcp.2010.0260","DOI":"10.4065\/mcp.2010.0260"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Brenner DJ, Hall EJ. Computed tomography - an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-2284. https:\/\/doi.org\/10.1056\/NEJMra072149","DOI":"10.1056\/NEJMra072149"},{"key":"ref9","unstructured":"Friberg EG. HERCA European Action Week - results of a coordinated inspection initiative assessing justification in radiology. www.herca.org\/wp-content\/uploads\/uploaditems\/documents\/161108%20-%20Inspection%20week\/IAEA%20Paper%20EFriberg.pdf (Jan 2026)"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Foley SJ, Bly R, Brady AP, et al. Justification of CT practices across Europe: results of a survey of national competent authorities and radiology societies. Insights Imaging. 2022;13(1):177. https:\/\/doi.org\/10.1186\/s13244-022-01325-1","DOI":"10.1186\/s13244-022-01325-1"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Patridge EF, Bardyn TP. Research electronic data capture (REDCap). J Med Libr Assoc. 2018;106(1):142-144. https:\/\/doi.org\/10.5195\/jmla.2018.319","DOI":"10.5195\/jmla.2018.319"},{"key":"ref12","unstructured":"Region Nordjylland. Politikker, retningslinjer og instrukser [Politics, guidelines and instructions]. https:\/\/pri.rn.dk (Mar 2023)"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Masuadi E, Mohamud M, Almutairi M, et al. Trends in the usage of statistical software and their associated study designs in health sciences research: a bibliometric analysis. Cureus. 2021;13(1):e12639. https:\/\/doi.org\/10.7759\/cureus.12639","DOI":"10.7759\/cureus.12639"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Bou\u00ebtt\u00e9 A, Karoussou-Schreiner A, Le Pointe HD, et al. National audit on the appropriateness of CT and MRI examinations in Luxembourg. Insights Imaging. 2019;10(1):54. https:\/\/doi.org\/10.1186\/s13244-019-0731-9","DOI":"10.1186\/s13244-019-0731-9"},{"key":"ref15","unstructured":"Alm\u00e9n A, Leitz W, Richter S. 2009:03 National survey on justification of CT-examinations in Sweden. Swedish Radiation Safety Authority, 2009. www.stralsakerhetsmyndigheten.se\/en\/publications\/reports\/radiation-protection\/2009\/200903\/ (Jan 2026)"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"St\u00e5hlbrandt H, Bj\u00f6rnfot I, Cederlund T, Alm\u00e9n A. CT and MRI imaging in Sweden: retrospective appropriateness analysis of large referral samples. Insights Imaging. 2023;14(1):134. https:\/\/doi.org\/10.1186\/s13244-023-01483-w","DOI":"10.1186\/s13244-023-01483-w"},{"key":"ref17","unstructured":"Danish Health Authority. Pakkeforl\u00f8b for kr\u00e6ft [Danish cancer pathway guidelines]. https:\/\/sst.dk\/vidensbase\/sygdomme-og-behandling\/kraeftsygdom\/kraeftpakkeforloeb (2 Mar 2025)"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Vom J, Williams I. Justification of radiographic examinations: what are the key issues? J Med Radiat Sci. 2017;64(3):212-219. https:\/\/doi.org\/10.1002\/jmrs.211","DOI":"10.1002\/jmrs.211"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Khalifa M, Albadawy M. AI in diagnostic imaging: revolutionising accuracy and efficiency. Comput Methods Programs Biomed Update. 2024;5:100146. https:\/\/doi.org\/10.1016\/j.cmpbup.2024.100146","DOI":"10.1016\/j.cmpbup.2024.100146"}],"container-title":["Danish Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:34:47Z","timestamp":1773923687000},"score":1,"resource":{"primary":{"URL":"https:\/\/ugeskriftet.dk\/dmj\/A07250557"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":20,"URL":"https:\/\/doi.org\/10.61409\/a07250557","relation":{},"ISSN":["2245-1919"],"issn-type":[{"value":"2245-1919","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}