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Biomedical subjects

W P Ennis

Publications and source records attributed to W P Ennis.

8 recordsLinked to original sources
PubMed1990

Radiography of the paranasal sinuses--one or three views?

A prospective study of 100 adult patients undergoing paranasal sinus radiography was performed. Two experienced radiologists independently assessed a single occipitomental view and, at a later date, the traditional three projections, i.e. occipitomental, occipitofrontal and lateral. There was 99% intra-observer agreement between the diagnosis on a single projection compared with all three films. In five cases, the frontal sinuses were difficult to assess mainly due to poor radiography, and in defined circumstances additional views may be required occasionally. We conclude that with greater attention to radiographic technique the occipitomental view alone is sufficient for diagnostic purposes.

Adolescent↗
PubMed1987

Can the use of radiography of arms and legs in accident and emergency units be made more efficient?

The efficiency of the selection of patients with injured arms and legs for radiography was investigated. The analysis was based on data on presenting signs and symptoms collected in a multicentre study organised by the Royal College of Radiologists working party on the effective use of diagnostic radiology. The work was carried out in eight accident and emergency units in England and Wales. With the help of various computer simulation techniques a combination of signs and symptoms that might usefully improve present practice was sought. The results suggest that for injuries of arms and legs the clinical determinants of bony injury cannot be refined further to improve current selection for radiography. This study shows that existing clinical practice is probably as good as it can be.

Accidents↗
PubMed1986

Admission guidelines for head injuries: variance with clinical practice in accident and emergency units in the UK.

Guidelines for the initial management of head injuries were formulated by neurosurgeons and a multidisciplinary group of clinicians and administrators attending a seminar convened by the UK Department of Health and Social Security (DHSS). Analysis of data collected previously by the Royal College of Radiologists in nine accident and emergency units in the UK shows that admitting practice varied between centres and was very different from that recommended subsequently in the guidelines. Only 49 per cent (range 22 to 71 per cent) of patients who had skull X-rays and possessed symptoms and signs warranting admission were admitted to hospital and 14 per cent (range 1 to 20 per cent) of those without appropriate symptoms and signs were admitted. Rates of admission for patients with a history of unconsciousness, which according to the guidelines is not a criterion for admission, were up to ten-fold higher than for comparable patients with no such history. Implementation of the guidelines could have a substantial effect on clinical practice and could reduce admissions of patients who had skull X-rays by up to 46 per cent.

Adult↗
PubMed1984

A pilot evaluation of radiography of the acute abdomen.

A pilot study to assess the value of abdominal films in acute surgical admissions was undertaken. The effect of chest and abdominal radiographs on the initial management of 100 consecutive patients was assessed. A management change of 10% was found and the implications are discussed. Patients with non-specific abdominal pain and women under 40 years of age had normal radiography. Pregnancy should first be excluded in the latter group.

Abdomen, Acute↗
PubMed1983

Possible impact of audit on chest X-ray requests from surgical wards.

Use of chest X-rays in the surgical wards of two district general hospitals was monitored from 1976 to 1980. Utilisation fell by 42% in one hospital and by 26% in the other. There was no evidence that substantial reduction in the use of chest X-rays was associated with increased postoperative morbidity (as reflected in postoperative length of stay) or mortality. Indeed in one hospital there was a significant fall in postoperative length of stay and postoperative mortality during the study period. It is likely that publicity given to the overuse of preoperative chest X-rays and to the guidelines for more effective use which subsequently emerged has played an important part in bringing about the observed reduction in use of this investigation.

Costs and Cost Analysis↗
PubMed1979

Precision in estimating gestational age and its influence on sensitivity of alphafetoprotein screening.

The interpretation of maternal serum alpha-fetoprotein (AFP) concentrations in relation to fetal neural tube defects depends on accurate assessment of the gestational age. In a quadruple-blind study three antenatal methods of assessment--namely, menstrual dates, clinical examination, and ultrasound scanning--were correlated with postnatal assessment using the Dubowitz scoring system. The best agreement to +/- 1 week was obtained using menstrual dates and ultrasound in combination, such agreement being found in 91 (77%) of the 118 women studied. Since serum AFP concentrations vary with gestational age, precise gestational dating is necessary. In many cases, particularly in women who are unsure of their dates or have irregular menstrual cycles, ultrasound examination is needed to supplement clinical findings.

Clinical Trials as Topic↗