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Impact of clinical information on CT diagnosis by radiologist and subsequent clinical management by physician in acute abdominal pain

  • Emergency Radiology
  • Published:
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The impact of clinical information on radiological diagnoses and subsequent clinical management has not been sufficiently investigated. This study aimed to compare diagnostic performance between radiological reports made with and without clinical information and to evaluate differences in the clinical management decisions based on each of these reports.


We retrospectively reviewed 410 patients who presented with acute abdominal pain and underwent unenhanced (n = 248) or enhanced CT (n = 162). Clinical information including age, sex, current and past history, physical findings, and laboratory tests were collected. Six radiologists independently interpreted CTs that were randomly assigned with or without clinical information, made radiological diagnoses, and scored the diagnostic confidence level. Four general and emergency physicians simulated clinical management (i.e., followed up in the outpatient clinic, hospitalized for conservative therapy, or referred to other departments for invasive therapy) based on reports made with or without the clinical information. Reference standards for the radiological diagnoses and clinical management were defined by an independent expert panel.


The radiological diagnoses made with clinical information were more accurate than those made without clinical information (93.7% vs. 87.8%, p = 0.008). Median interpretation time for radiological reporting with clinical information was significantly shorter than that without clinical information (median 122.0 vs. 139.0 s, p < 0.001). Clinical simulation better matched the reference standard for clinical management when radiological diagnoses were made with reference to clinical information (97.3% vs. 87.8%, p < 0.001).


Access to adequate clinical information enables accurate radiological diagnoses and appropriate subsequent clinical management of patients with acute abdominal pain.

Key Points

Radiological interpretation improved diagnostic accuracy and confidence level when clinical information was provided.

Providing clinical information did not extend the interpretation time required by radiologists.

Radiological interpretation with clinical information led to correct clinical management by physicians.

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Area under the curve

CM+ :

Clinical management based on radiological report made with clinical information


Clinical management based on radiological report made without clinical information


Integrated discrimination improvement


Net reclassification improvement


Non-specific abdominal pain


Picture archiving and communication systems


Radiological diagnosis made with clinical information


Radiological diagnosis made without clinical information


Reference standard for radiological diagnosis


Reference standard of clinical management


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Correspondence to Hajime Yokota.

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The scientific guarantor of this publication is Hajime Yokota.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Informed consent was obtained in the form of opt-out; those who opted out were excluded from the study.

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Institutional Review Board approval was obtained.


• diagnostic or prognostic study

• multicenter study

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Hattori, S., Yokota, H., Takada, T. et al. Impact of clinical information on CT diagnosis by radiologist and subsequent clinical management by physician in acute abdominal pain. Eur Radiol 31, 5454–5463 (2021).

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