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  • Title: The appropriateness of use and the clinical impact of micturating cystourethrography in paediatric practice.
    Author: Mussurakis S, Sprigg A, Steiner GM.
    Journal: Clin Radiol; 1994 Aug; 49(8):541-5. PubMed ID: 7955866.
    Abstract:
    STUDY OBJECTIVE: To determine the appropriateness of use and the clinical impact of micturating cystourethrography (MCU) in paediatric practice. DESIGN: Retrospective medical record review. SETTING: A major teaching children's hospital in the Trent region. PATIENTS: Consecutive sample of 120 children undergoing MCU during 1991-1992, identified from the radiology records. MAIN OUTCOME MEASURES: The referring clinician's reasons for requesting an MCU; the clinical management plan pursued before and after the MCU, and the change in management initiated by the result of the examination; the appropriateness of use of the test, as determined by the presence or absence of a valid indication for MCU in the specific clinical situation. RESULTS: The change in patient management attributable to the MCU result could be categorized as: no change (19%); decision to end the imaging investigation of the patient (33%); decision to end all investigations, and prophylactic or therapeutic interventions (16%); decision to discontinue chemoprophylaxis (2%); decision to end the imaging investigation and introduce chemoprophylaxis and follow-up for bacteriuria (6%); decision to continue the imaging investigation and introduce chemoprophylaxis and follow-up for bacteriuria (13%); and decision to operate or help in planning the surgical treatment required (11%). Inappropriate use of the test was observed in 20% of the cases. CONCLUSIONS: This study provides a basis for understanding the use of MCU in paediatric practice. The findings that 19% of the cystourethrograms had no appreciable effect, and that 20% of the examinations were used inappropriately show the need for increased effort to minimize overuse of the test.
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