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Title page                                                                                                                                                                            i

Dedication                                                                                                                                                                          ii

Approval page                                                                                                                                                                   iii

Certification                                                                                                                                                                       iv

Acknowledgement                                                                                                                                                         v

Table of content                                                                                                                                                               vi

List of tables                                                                                                                                                                       viii

Abstract                                                                                                                                                                               ix

CHAPTER ONE: INTRODUCTION                                                                                                                                 1

Background of the study                                                                                                                                              1

Statement of the problem                                                                                                                                          2  Objective of the study                                                                                                                                                     3

Significance of the study                                                                                                                                               3

Scope of the study                                                                                                                                                          4

Literature review                                                                                                                                                             5

CHAPTER TWO: THEORETICAL BACKGROUND                                                                                                      20

Qualified medical practitioner                                                                                                                                    20

The referrer                                                                                                                                                                       23

Appropriate delegation                                                                                                                                                 24

Referral process                                                                                                                                                               24

Radiological requesting guidelines                                                                                                                            25

Methods of radiology requesting                                                                                                                             26

Referrers to radiology                                                                                                                                                    28

Declining radiology requests                                                                                                                                       29

Electronic request                                                                                                                                                           33

Choice of IT system                                                                                                                                                         34

The benefits                                                                                                                                                                      34

Planning and implementing electronic remoter requesting system                                                           35

CHAPTER THREE: RESEARCH METHODOLOGY                                                                                                       38

Research design                                                                                                                                                               38

Study population                                                                                                                                                             38

Sample size                                                                                                                                                                        38

Method of data collection                                                                                                                                            38

Selection criteria                                                                                                                                                              39

Method of data analysis                                                                                                                                                               39

CHAPTER FOUR: DATA ANALYSIS AND PRESENTATION                                                                                    40


Discussion                                                                                                                                                                           49

Summary                                                                                                                                                                             52

Recommendation                                                                                                                                                            53

Conclusion                                                                                                                                                                          53

Reference                                                                                                                                                                           5

List of tables

Table 1a: Distributions of patient bio-data information inadequately completed by referring clinicians in UNTH.

Table1b: distributions showing clinical information inadequately filled by the referring clinicians in UNTH.

Table1c: distributions showing ancillary information not completed by the referring clinicians in UNTH

Table2a: distributions of patient bio-data information that inadequately completed by referring clinicians in ESUTH.

Table2b:  distributions showing clinical information inadequately filled by the Referring clinicians in ESUTH

Table2c: distributions showing ancillary information not completed by the referring clinicians in ESUTH

Table3: distributions showing the number of adequately and inadequately filled request forms by various clinicians in UNTH.

Table4: distributions showing the number of adequately and inadequately filled request forms by various clinicians in UNTH.

Table5: comparison between adequately filled request forms in UNTH and ESUTH


An inadequately filled radiology request form (RRF) is a common problem faced by both radiologists and radiographers. The study was designed to objectively assess the adequacy of filling of radiology request forms from two hospitals in Enugu metropolis: University of Nigeria Teaching Hospital, UNTH) Ituku-ozalla and Enugu State Teaching Hospital, (ESUTH) Parklane

Method; Radiological request forms were collected from the archiving shelves and analyzed using criteria about patient data, clinical information and referring clinician’s identity

A total number of 4158 request forms were analyzed, 2050 from the university of Nigeria Teaching Hosiptal(UNTH) Ituku-ozala and 2108 from the Enugu state university Teaching Hospital(ESUTH) parklane. Out of the total number (4158) analyzed, 3280 (78.88%) were inadequately filled by the referring clinicians while 878(21.1%) were adequately filled. 443(21.6%) were adequately filled and 1607(78.4%) were inadequately filled from UNTH while 435(20.6%) were adequately filled and 1673(79.3%) were inadequately filled from ESUTH.  Conclusion; Evaluation of the radiological request form currently in use at the UNTH and ESUTH revealed the existence of important omission and mild compliance with filling of fields requested by referring clinicians.




A radiology request form is clinical document completed by a licensed physician stating what procedure or examination is desired. This document contains what examination needs to be done, why the examination needs to be conducted and on whom the examination will be performed. Also, inherent in the radiology request form is the clinical question that needs to be answered. The clinical question can come in many forms such as ‘’what is the cause of fever and leukocytosis in this patient” or ‘’is this tumour malignant or benign” or ‘’is there a fracture?’’ though this question is not always explicity stated, it is important that the radiologist knows and identifies the clinical question inherent in the request form1. A properly completed request form is essential for proper reimbursement and to increase the efficiency of the radiology requesting process. Pertinent identifiers such as name and date of birth are necessary in a proper request from. Also a succinct and adequate clinical history is needed for the radiologist to make the proper clinical diagnosis and for the health care provider to be properly reimbursed.1

Radiology request forms are essential communication tools used by hospital and doctors referring patients for radiological investigations. However, their importance is highly underestimated2,6

Request form should be completed accurately and legibly to avoid any misinterpretation. The clinician is required to state the reason for referral as this helps radiologist to better understand the patient’s condition so that the required expertise may be utilized to proffer the necessary information to aid appreciate patient management3. In a large percentage of patients, radiology request forms play pivotal role in both diagnosis and treatment, central to this is the adequate completion of the radiology request forms. Unfortunately, most request forms encountered by radiographers in diagnosis room are inadequately filled by the referring clinician4. Choosing the appropriate investigation at the right time and providing correct biographic and clinical information of the patient is the responsibility of the clinician or medical practitioner requesting for radiological investigation2. The assessment of adequate filling of request form by the referring clinicians is the aim of the study.                                                                             1.2  STATEMENT OF PROBLEM

  1. There is doubt whether the referring clinicians adhere to the guidelines given by the Royal Collage of Radiologist for adequately filling of Radiology request form.
  2. It is not certain if inadequately filled Radiology request form, affects the diagnosis of the patient.
  3. To evaluate the filling of radiology request form by the referring clinicians.
  4. To compare adequacy filling of radiological request form in the two hospitals which included University of Nigeria Teaching Hospital Ituku-Ozalla (UNTH) Ituku-ozalla and Enugu State University Teaching Hospital (ESUTH) in relation to the clinic/wards referring the patient


  1. This study may be of immense help reviewing the need for proper filling of radiology request form.
  2. It may serve as educative material to reduce misdiagnosis
  3. It may help to reduce misinterpretation of radiographs when unnecessary region of the body is exposed because of incompletely filled request form.
  4. It may helps to enlighten radiographers to avoid unhelpful radiographic examinations performed and aids concise radiological diagnosis.
  5. It also indirectly helps to reduce the investigation time and improve the quality of services offered to the patients by radiographers and clinicians.



The study assessed request forms sent to radiology department in two Government owned hospital in Enugu metropolis which included University of Nigeria Teaching Hospital Ituku-Ozalla (UNTH) and Enugu State University Teaching Hospital (ESUTH) for adequacy of information, for a period of one year (from January –December, 2012)s


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