A survey on the amount of unnecessary brain and spine magnetic resonance imaging and reasons to affect it in Tehran, Iran

Sara Akhavan Rezayat, Sara Emam Gholi Pour, Afsaneh AliKhassi, Zohreh Habibi and Batoul Ahmadi

International Journal of Finance & Economics, 2023, vol. 28, issue 1, 996-1005

Abstract: Objectives Analyzing and understanding image recognition technologies' application patterns is of great importance for health planning systems, especially in the middle‐ and low‐income countries. The literature review reveals that magnetic resonance imaging has been significantly used worldwide compared to other imaging diagnoses. This study aimed to determine the number of unnecessary MRIs in 2015, 2016, and 2017, thus reducing them using the obtained information. Methods and materials This descriptive‐analytical and Retrospective study was carried out in 2015, 2016, and 2017. The Cochran formula was used to determine the sample volume: where P = q = 0.5 at the significance level of 5%, and N represented the statistical population. Since the number of hospitalized MRIs during these three years was 1,617, 1,499, and 2,090, the sample size was 310, 305, and 325. Finally, 940 cases were included in the study. The samples were randomly selected. MRI request indexes design and data were collected based on the AIM guidelines. Finally, by choosing specific indications based on the brain and spinal MRI guidelines and adding indications to software and data, they were analyzed using the SPSS23 software and chi‐square test. Chi ‐ squares test was used to measure the significance of the data. Results According to the present study and based on the indications and diagnoses related to brain and spinal cord diseases extracted from inpatients' records, 20% of prescriptions were unnecessary; of all unnecessary requested MRIs, 70.8% related to the brain and 29.2% to the spine. Moreover, the notable point was the lack of MRI response in 18.3% of the cases. In this study, 35% (most) of the unnecessary MRIs were prescribed by physicians with non‐neurological and non‐orthopedic specialties. On the other hand, non‐stamped MRI requests accounted for a significantly higher share of unnecessary MRIs (49.8%). Examining physicians' type of activity and work experience shows that the highest share of unnecessary prescriptions (almost 50%) was related to physicians' non‐stamped records. Conclusion Factors such as professional certainty, more time for examination, prescription of MRI by a related physician, supervision of professors of the medical department on the prescriptions of less experienced physicians, failure to perform MRI of unstamped files by master or residents by the imaging center, and the need to use indications Guideline‐compliant prescriptions can reduce unnecessary patient and health system. So, it is essential to consider some aspects for reducing unnecessary requests in any subject of the health system.

Date: 2023
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