instruction stringlengths 128 1.06k | appropriateness stringclasses 4
values | evidence stringlengths 2 90k | strength_of_evidence stringclasses 7
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Judge the appropriateness of administering a Magnetic Resonance Imaging head without Intravenous contrast on a patient with the following characteristics: child. Six months of age or older. Papilledema detected on the ophthalmologic examination or signs of raised intracranial pressure. Initial imaging. | may be appropriate | [{'PMID': 27585209, 'Study Quality': '4'}, {'PMID': 23966248, 'Study Quality': '4', 'title': 'Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children.', 'abstract': 'The pseudotumor cerebri syndrome (PTCS) may be primary (idiopathic intracranial hypertension) or arise from an identifiabl... | limited | usually appropriate | may be appropriate (disagreement) | may be appropriate | usually not appropriate | C |
Determine the appropriateness of administering a Computed Tomography neck without Intravenous contrast on a patient with the following characteristics: unilateral isolated palatal or vocal cord paralysis or both (vagal nerve, CN X). Initial imaging. | may be appropriate | [{'PMID': 27670956, 'Study Quality': '4', 'title': 'Repeat Imaging in Idiopathic Unilateral Vocal Fold Paralysis: Is It Necessary?', 'abstract': 'OBJECTIVE: Imaging plays a critical role in the evaluation of patients presenting with unilateral vocal fold paresis or paralysis of unknown etiology. In those with idiopathi... | strong | may be appropriate | may be appropriate (disagreement) | usually not appropriate | usually appropriate | A |
Scrutinize the appropriateness of providing a Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography whole body on a patient with the following characteristics: ovarian cancer screening. Premenopausal. High risk (personal history or family history or known or suspected genetic predisposition or elevated CA... | usually not appropriate | [] | expert consensus | may be appropriate | may be appropriate (disagreement) | usually appropriate | usually not appropriate | D |
Judge the appropriateness of administering a Midline catheter on a patient with the following characteristics: device selection: Acutely ill patient requiring infusion of vesicant medication, hemodynamic monitoring, and frequent blood draws for 2 weeks or shorter. | may be appropriate | [{'PMID': 34553435, 'Study Quality': '2'}, {'PMID': 24811603, 'Study Quality': '1'}] | strong | may be appropriate | may be appropriate (disagreement) | usually not appropriate | usually appropriate | A |
Investigate the appropriateness of performing a Computed Tomography maxillofacial with Intravenous contrast on a patient with the following characteristics: pain with upper jaw manipulation or pain overlying zygoma or zygomatic deformity or facial elongation or malocclusion or infraorbital nerve paresthesia. Suspect mi... | usually not appropriate | [{'PMID': 29320322, 'Study Quality': '4'}, {'PMID': 30454777, 'Study Quality': '4'}, {'PMID': 28941512, 'Study Quality': '4'}, {'PMID': 27618328, 'Study Quality': '4'}, {'PMID': 27761894, 'Study Quality': '4'}, {'PMID': 24183372, 'Study Quality': '4'}, {'PMID': 23322824, 'Study Quality': '4'}, {'PMID': 22472677, 'Study... | limited | usually appropriate | may be appropriate | usually not appropriate | may be appropriate (disagreement) | C |
Determine the appropriateness of executing a Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh on a patient with the following characteristics: chronic dyspnea. Suspected disease of the pleura or chest wall. Initial imaging. | usually not appropriate | [] | expert consensus | usually appropriate | may be appropriate (disagreement) | may be appropriate | usually not appropriate | D |
Scrutinize the appropriateness of providing a Fluoroscopy contrast enema on a patient with the following characteristics: palpable abdominal mass. Suspected abdominal wall mass. Initial imaging. | usually not appropriate | [{'PMID': 25064764, 'Study Quality': '4', 'title': 'Soft-tissue masses in the abdominal wall.', 'abstract': 'Masses involving the abdominal wall arise from a large number of aetiologies. This article will describe a diagnostic approach, imaging features of the most common causes of abdominal wall masses, and highly spe... | expert consensus | may be appropriate | usually not appropriate | usually appropriate | may be appropriate (disagreement) | B |
Scrutinize the appropriateness of providing a Magnetic Resonance Angiography head and neck without Intravenous contrast on a patient with the following characteristics: new focal neurologic defect, fixed or worsening. Longer than 6 hours. Suspected stroke. | usually appropriate | [] | not specified | usually appropriate | may be appropriate (disagreement) | may be appropriate | usually not appropriate | A |
Survey the appropriateness of delivering a Magnetic Resonance Imaging hand without and with Intravenous contrast on a patient with the following characteristics: initial radiographs showing metacarpophalangeal, proximal interphalangeal, or distal interphalangeal joint malalignment in the absence of fracture. Next imagi... | usually not appropriate | [{'PMID': 11818612, 'Study Quality': '3', 'title': 'MR imaging of the metacarpophalangeal joints of the fingers: part II. Detection of simulated injuries in cadavers.', 'abstract': 'PURPOSE: To evaluate and compare conventional magnetic resonance (MR) imaging and MR arthrography in the diagnosis of the most common trau... | limited | usually not appropriate | may be appropriate | usually appropriate | may be appropriate (disagreement) | A |
Review the appropriateness of conducting a Magnetic Resonance Imaging hip without Intravenous contrast on a patient with the following characteristics: chronic hip pain. Suspect impingement or dysplasia. Radiographs negative or nondiagnostic. Next imaging study. | usually appropriate | [{'PMID': 15800516, 'Study Quality': '2', 'title': 'Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging.', 'abstract': 'PURPOSE: Traditional imaging techniques have limited ability to detect subtle chondral and labral injuries of the hip. We performed a retros... | strong | usually not appropriate | may be appropriate (disagreement) | usually appropriate | may be appropriate | C |
Analyze the appropriateness of providing a Radiography chest on a patient with the following characteristics: known or suspected infective endocarditis. Additional imaging to direct patient management or treatment. | may be appropriate | [{'PMID': 6519077, 'Study Quality': '2', 'title': 'Prosthetic valve endocarditis: clinical findings and management.', 'abstract': 'Prosthetic valve endocarditis (PVE) was shown in 46 patients out of a group of 2163 carrying prosthetic heart valves. The cumulative rate of early PVE was 1.4% and 1.5% for PVE occurring be... | expert consensus | may be appropriate | usually not appropriate | may be appropriate (disagreement) | usually appropriate | A |
Consider the appropriateness of providing a Magnetic Resonance Angiography head without Intravenous contrast on a patient with the following characteristics: child. Clinical presentation suggestive of acute stroke, known or suspected high-flow vascular anomaly. Initial imaging. | usually appropriate | [{'PMID': 25063989, 'Study Quality': '3'}] | expert consensus | usually appropriate | usually not appropriate | may be appropriate | may be appropriate (disagreement) | A |
Consider the appropriateness of undertaking a Image-guided core biopsy breast on a patient with the following characteristics: adult female, 40 years of age or older. Palpable breast mass. Mammography findings are suspicious or highly suggestive of malignancy (BI-RADS 4 or 5). Next imaging study. | usually not appropriate | [{'PMID': 17924407, 'Study Quality': '3', 'title': 'A comparative analysis of core needle biopsy and fine-needle aspiration cytology in the evaluation of palpable and mammographically detected suspicious breast lesions.', 'abstract': 'The present study was undertaken to compare the efficacy of needle core biopsy (NCB) ... | limited | may be appropriate | usually not appropriate | usually appropriate | may be appropriate (disagreement) | B |
Investigate the appropriateness of performing a Radiography abdomen and pelvis on a patient with the following characteristics: suspected deep pelvic hernia including obturator, sciatic, or perineal. Initial imaging. | usually not appropriate | [{'PMID': 22138700, 'Study Quality': '4'}, {'PMID': 24078001, 'Study Quality': '4'}, {'PMID': 26985818, 'Study Quality': '4'}] | not specified | usually not appropriate | may be appropriate | usually appropriate | may be appropriate (disagreement) | A |
Examine the appropriateness of offering a Ultrasound area of interest on a patient with the following characteristics: child. Established diagnosis of vascular malformation presenting with new or persistent signs or symptoms. Initial imaging. | may be appropriate | [{'PMID': 26444594, 'Study Quality': '3'}] | expert consensus | may be appropriate | usually appropriate | may be appropriate (disagreement) | usually not appropriate | A |
Analyze the appropriateness of providing a Computed Tomography abdomen without and with Intravenous contrast on a patient with the following characteristics: suspected acute pyelonephritis. History of renal stones or renal obstruction. Initial imaging. | may be appropriate (disagreement) | [{'PMID': 18203942, 'Study Quality': '4', 'title': 'Pyelonephritis: radiologic-pathologic review.', 'abstract': 'Urinary tract infections are the most common urologic disease in the United States and annually account for over 7 million office and 1 million emergency department visits. In adults, diagnosis of urinary tr... | expert opinion | may be appropriate | may be appropriate (disagreement) | usually appropriate | usually not appropriate | B |
Survey the appropriateness of delivering a Computed Tomography chest with Intravenous contrast on a patient with the following characteristics: confirmed diffuse lung disease without acute clinical deterioration. Routine follow-up imaging clinically indicated. | may be appropriate | [{'PMID': 8153310, 'Study Quality': '2', 'title': 'Chronic diffuse infiltrative lung disease: determination of the diagnostic value of clinical data, chest radiography, and CT and Bayesian analysis.', 'abstract': 'PURPOSE: To assess the value of clinical, chest radiographic, and computed tomographic (CT) findings in cl... | strong | usually not appropriate | usually appropriate | may be appropriate (disagreement) | may be appropriate | D |
Appraise the appropriateness of delivering a Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh on a patient with the following characteristics: nontraumatic chest wall pain. Suspected infectious or inflammatory condition. Secondary evaluation after normal chest radiograph. Next... | may be appropriate | [{'PMID': 25917543, 'Study Quality': '4'}, {'PMID': 30205705, 'Study Quality': 'Not Assessed'}, {'PMID': 23359660, 'Study Quality': '4'}, {'PMID': 17954662, 'Study Quality': '4'}] | moderate | usually appropriate | may be appropriate (disagreement) | may be appropriate | usually not appropriate | C |
Gauge the appropriateness of executing a Magnetic Resonance Imaging head without and with Intravenous contrast on a patient with the following characteristics: unilateral isolated weakness of the facial expression, paralysis of the facial expression, hemifacial spasm, or Bell palsy (facial nerve, CN VII). Initial imagi... | usually appropriate | [{'PMID': 22784861, 'Study Quality': '3', 'title': 'Clinical feasibility of temporal bone magnetic resonance imaging as a prognostic tool in idiopathic acute facial palsy.', 'abstract': 'OBJECTIVE: To assess the feasibility of temporal bone magnetic resonance imaging for evaluating the severity and prognosis of idiopat... | strong | usually appropriate | may be appropriate | usually not appropriate | may be appropriate (disagreement) | A |
Measure the appropriateness of undertaking a Magnetic Resonance Imaging head without Intravenous contrast on a patient with the following characteristics: follow-up for clinically localized renal cell carcinoma; post radical or partial nephrectomy. | usually not appropriate | [{'PMID': 23665399, 'Study Quality': '4', 'title': 'Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline.', 'abstract': 'PURPOSE: The purpose of this guideline is to provide a clinical framework for follow-up of clinically localized renal neoplasms undergoing active surveillance, or following definitive th... | limited | usually not appropriate | may be appropriate | usually appropriate | may be appropriate (disagreement) | A |
Weigh the appropriateness of administering a Computed Tomography head without and with Intravenous contrast on a patient with the following characteristics: child. Nontraumatic subarachnoid hemorrhage (SAH) detected by noncontrast Computed Tomography Next imaging study. | usually not appropriate | [{'PMID': 24156863, 'Study Quality': '4'}] | limited | may be appropriate | may be appropriate (disagreement) | usually appropriate | usually not appropriate | D |
Measure the appropriateness of undertaking a Ultrasound chest on a patient with the following characteristics: recent pneumonia with suspected parapneumonic effusion or empyema. Initial imaging. | may be appropriate (disagreement) | [{'PMID': 19933660, 'Study Quality': '3'}, {'PMID': 11762545, 'Study Quality': '2'}, {'PMID': 30675767, 'Study Quality': '2'}, {'PMID': 27709281, 'Study Quality': '3'}, {'PMID': 19616366, 'Study Quality': '2'}, {'PMID': 11127008, 'Study Quality': '2'}, {'PMID': 33033148, 'Study Quality': '4'}, {'PMID': 27613540, 'Study... | expert opinion | usually appropriate | usually not appropriate | may be appropriate | may be appropriate (disagreement) | D |
Investigate the appropriateness of performing a Ultrasound duplex Doppler abdomen on a patient with the following characteristics: known multiorgan system arterial occlusions. Suspected embolic etiology. Next imaging study to determine source. | may be appropriate | [{'PMID': 21482138, 'Study Quality': '4'}] | limited | usually appropriate | may be appropriate | usually not appropriate | may be appropriate (disagreement) | B |
Survey the appropriateness of delivering a Magnetic Resonance Angiography chest without and with Intravenous contrast on a patient with the following characteristics: acute nonspecific chest pain; low probability of coronary artery disease. Initial imaging. | usually not appropriate | [{'PMID': 27533160, 'Study Quality': '4', 'title': 'Acute Aortic Dissection and Intramural Hematoma: A Systematic Review.', 'abstract': 'IMPORTANCE: Acute aortic syndrome (AAS), a potentially fatal pathologic process within the aortic wall, should be suspected in patients presenting with severe thoracic pain and hypert... | limited | may be appropriate | may be appropriate (disagreement) | usually appropriate | usually not appropriate | D |
Assess how appropriate it would be to perform a Red Blood Cells scan abdomen and pelvis on a patient with the following characteristics: adult. Endoscopy confirms nonvariceal upper gastrointestinal bleeding without a clear source. Initial imaging. | may be appropriate | [{'PMID': 23789659, 'Study Quality': '4', 'title': 'Multiphase CT enterography evaluation of small-bowel vascular lesions.', 'abstract': 'OBJECTIVE: By use of multiphase CT enterography (CTE), small-bowel vascular lesions associated with gastrointestinal bleeding can be classified into three categories--angioectasias, ... | expert consensus | may be appropriate | may be appropriate (disagreement) | usually not appropriate | usually appropriate | A |
Measure the appropriateness of undertaking a Ultrasound echocardiography transesophageal on a patient with the following characteristics: known or suspected congenital heart disease in the adult. | usually appropriate | [{'PMID': 2044558, 'Study Quality': '4', 'title': 'The role of transoesophageal echocardiography in adolescents and adults with congenital heart defects.', 'abstract': "Between April 1985 and December 1989, outpatient transoesophageal echocardiography was performed in 133 adolescent and adult patients (14% of all outpa... | moderate | usually appropriate | may be appropriate (disagreement) | usually not appropriate | may be appropriate | A |
Gauge the appropriateness of executing a Magnetic Resonance Imaging breast without Intravenous contrast on a patient with the following characteristics: newly diagnosed. Clinical stage I-IIA (early stage) breast cancer at presentation. Evaluation for locoregional disease (includes invasive ductal carcinoma [IDC], or in... | usually not appropriate | [{'PMID': 22751517, 'Study Quality': '4'}] | expert consensus | may be appropriate | usually not appropriate | may be appropriate (disagreement) | usually appropriate | B |
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