Computed Tomography for Abdominal Pain: Do Radiology Reports Answer the Clinical Question?

Rationale and Objectives: To assess whether abdominopelvic computed tomography (CT) radiology reports directly address a cause for pain when pain is included in the scan indication. Materials and Methods: Four hundred and ninety-five random abdominopelvic CT reports containing “pain” in the indication were retrospectively reviewed. The position of pain descriptors within the indication, the presence of an oncology-related indication in addition to pain and whether a cause for pain was addressed in the impression were recorded. Linguistic analysis of indication and impression sections was performed. Comparisons between reports that addressed pain and those that did not were conducted using Chi-square, Fisher exact, and two-tailed t-tests. Results: A cause for pain was addressed in 454 of 495 (91.7%) report impressions. Indications with both oncology-related and pain-related descriptors were less likely to have pain directly addressed (χ² (1, N = 495) = 16.4, p < .001). There was no significant association between where pain appeared within the indication and whether pain was addressed (χ² (1, N = 495) = 3.2, p = .07). Whether an impression conveyed a normal result did not influence if pain was addressed (p = .49). Impression word count and complexity were higher in the addressed group compared to the not addressed group (word count 66.6 vs. 51.9, p= .02, Composite grade level 30.1 vs. 25.3, p= .02). Conclusion: Radiologists at our institution consistently addressed a cause for pain on abdominopelvic CTs when pain was in the indication. However, oncology patients who also had an indication of pain were less likely to have a cause for pain addressed. Impression complexity was high for all reports, though higher in those where pain was addressed.