Evidence map›Paper›PMID 39804413›Full record

ArticleInsights into imaging2025

Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis.

Maria Isabel Opper Hernando, Denis Witham, Ann-Christine Stahl, Peter Richard Steinhagen, Stefan Angermair, Wolfgang Bauer, Friederike Compton, Andreas Edel, Jan Matthias Kruse, York Kühnle and 16 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Insights into imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Maria Isabel Opper HernandoDepartment of Radiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany. maria-isabel.opper-hernando@charite.de.ORCID http://orcid.org/0000-0003-4392-7431
Denis WithamDepartment of Cardiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Ann-Christine StahlDepartment of Radiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Peter Richard SteinhagenBerlin Institute of Health, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany.
Stefan AngermairDepartment of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, Berlin, Germany.
Wolfgang BauerEmergency Department, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, Berlin, Germany.
Friederike ComptonMedical Clinic with Focus on Nephrology and Internal Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, Berlin, Germany.
Andreas EdelDepartment of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1 and Augustenburger Platz 1, Berlin, Germany.
Jan Matthias KruseMedical Clinic with Focus on Nephrology and Internal Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1, Berlin, Germany.
York KühnleDepartment of Cardiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1, Berlin, Germany.
Gunnar LachmannBerlin Institute of Health, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany.
Susanne MarzInterdisciplinary Anesthesiology and Surgical Intensive Care Unit, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1 and Augustenburger Platz 1, Berlin, Germany.
Holger Müller-RedetzkyDepartment of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Jens NeeMedical Clinic with Focus on Nephrology and Internal Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1, Berlin, Germany.
Oliver PaulDepartment of Cardiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1, Berlin, Germany.
Damaris PraegerClinic for Cardiology, Angiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Carsten SkurkDepartment of Cardiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, Berlin, Germany.
Miriam StegemannDepartment of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Augustenburger Platz 1, Berlin, Germany.
Alexander UhrigDepartment of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Stefan WolfDepartment of Neurosurgery with Pediatric Neurosurgery Unit, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Myrto BolanakiEmergency Department, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1 and Augustenburger Platz 1, Berlin, Germany.
Kerstin RubarthInstitute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Joachim SeyboldMedical Directorate, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Elke ZimmermannDepartment of Radiology, Oberhavel Kliniken - Oberhavel Kliniken GmbH, Academic Teaching Hospital of the Charité - Universitätsmedizin Berlin, Hennigsdorf, Germany.
Marc DeweyDepartment of Radiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Julian PohlanDepartment of Radiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo survey physicians' views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.

methodsA web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians' work experience, workplace, and medical specialty as independent variables. Chi-square tests were used for exploratory analysis.

resultsWhile physicians with all levels of work experience were included, the largest group (35.0%, n = 130/371) had 3-7 years of experience. Most physicians agreed that the benefits of CT outweigh its potential adverse effects in septic patients (90.5%, n = 336/371). Responders saw the strongest indication for contrast media administration in septic patients for (1) CT examinations of the abdomen (92.7%, n = 333/359) and (2) combined CT examinations of the chest, abdomen, and pelvis (94.1%, n = 337/358). While radiologists were most likely to consider manifest hyperthyroidism an absolute contraindication to contrast media administration (43.8%, n = 14/32), most other groups of physicians opted for appropriate preparation before contrast media administration in this subset of septic patients.

conclusionIn this survey, most participating physicians considered CT an essential diagnostic modality to detect an infectious focus in septic patients. Whereas the risk of ionizing radiation was regarded as justifiable by most physicians, different specialties varied in their assessment of the risks of contrast media administration. KEY POINTS: Physicians recognize CT as a relevant imaging modality in the diagnostic management of patients with sepsis. There is an interdisciplinary consensus that the use of ionizing radiation is justified in septic patients. There is disagreement about indications for and contraindications to contrast media administration among physicians from different medical specialties.

Indexed as

Clinical reasoningContrast mediaSepsisSurveys and questionnairesTomography (X-ray computed)

Identifiers

PMID39804413
PMCPMC11730041

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.