• Rute Martins, Pedro Raimundo, Pedro Alves, Rodrigo Monteiro, Luís Duarte Silva, André Gomes, and Graça Afonso.
• Serviço de Radiologia. Centro Hospitalar Universitário do Algarve. Faro e Portimão. Algarve Biomedical Center. Faro. Portugal.
• Acta Medica Port. 2020 Jan 3; 33 (1): 7-14.

IntroductionImaging tests are essential for diagnosis in the emergency context and convey clinical information that is essential to assess the appropriateness of the tests and improve their interpretation. Therefore, we aimed to analyze the imaging tests requested by the Emergency Department in a district hospital.Material And MethodsWe retrospectively analyzed computed tomography and ultrasound scans requested by the Emergency Department at the Centro Hospitalar Universitário do Algarve and considered the following variables: requested test, clinical information provided (complete/incomplete), appropriateness of the test (appropriate/inappropriate), outcome (presence/absence of relevant findings) and findings related to the clinical information (yes/no). Pearson's chi-squared and odds ratio association tests were used to evaluate the statistical association between the variables.ResultsOut of 1427 requests, only 219 (15.3%) were considered to have complete clinical information. Nonetheless, 1075 (75.3%) requests were considered appropriate. Relevant findings were present in about one-third (n = 453; 31.7%) and most of these findings were related to the clinical context (n = 410; 90.5%). There was a significant association between test appropriateness and the presence of relevant findings in the test (p < 0.001). The odds ratio of having a relevant finding was 5.0 times higher in the tests considered appropriate when compared with those classified as inappropriate (CI = 3.4 - 7.3; p < 0.001).DiscussionThe fact that appropriate tests potentiate the probability of having a relevant finding emphasizes the importance of defining guidelines so that only the adequate tests are performed.ConclusionCreating guidelines should improve the appropriateness of imaging tests requested in the Emergency Department, yielding their result, with the consequent rationalization of the available resources.

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