Title:Guideline Adherence as an Indicator of PET Scan Overuse in an Italian
Teaching Hospital: An Observational Study
Volume: 18
Issue: 1
Author(s): Giuseppe Lucio Cascini, Marianna Mauro*, Barbara Catalfamo, Monica Giancotti and Roberta Muraca*
Affiliation:
- Department of Clinical and Experimental Medicine, Magna Graecia University, 88100 Catanzaro, Italy
- Department of Law, Economics
and Sociology, Magna Graecia University, 88100 Catanzaro, Italy
Keywords:
Overuse, healthcare services, healthcare utilization, inappropriate care, excessive testing, unnecessary treatments, adherence to guidelines.
Abstract:
Background: Evidence of inappropriate overuse and underuse of medical procedures
has been documented in modern healthcare systems around the world. Excessive use of health
services can contribute to a rapid increase in healthcare costs and harm the patient physically
and psychologically; conversely, underuse can lead to the inability to provide effective treatments
when clinically indicated.
Objective: The study's aim is twofold: a) to measure the appropriateness of PET prescription in
a cohort of patients, offering empirical evidence of overuse of health care services; b) to evaluate
how the overuse of PET could affect public health expenditure and, consequently, the system's
financial sustainability.
Methods: In this observational study, we have analyzed prospectively and retrospectively health
patient records who underwent 18F-FDG PET/TC scan at the Nuclear Medicine Department of
the University Hospital Mater Domini in Catanzaro (Italy) from 29/09/2022 to 10/02/2023. Patients’
diagnostic questions have been defined as appropriate, not completely appropriate and
completely inappropriate according to the 18F-FDG PET/CT recommendations defined by the
“Conditions of Supply and Indications of Prescriptive Appropriateness of Italian NHS (National
Health Systems)” published in the Official Gazette no. 15 of 20 January 2016 (Decree 9 December
2015) and by the AIMN (Italian Association of Nuclear Medicine) guidelines
Results: We gathered data from 500 oncological patients (242 males and 258 females). The results
show that 423/500 of patients' prescriptions were appropriate, while 77/500 of patients'
prescriptions were completely inappropriate (63/77) or not completely appropriate (14/77).
Conclusion: Analysis showed a not complete adherence to national guidelines and no shared
decision-making approach.
