The nation-wide register of hospital discharges in Norway includes ICD-9 and national procedure codes. Hospitals were asked to check five surgical procedures listed in the register against the primary data sources. 649 discharges were controlled. The response rate was 68%. The results indicate that the quality of the data in the register varies for the different procedures. For procedures with high volume (resection of rectum), the error in the register is 3%. This is the same as reported from other Nordic countries. The proportion of errors in the register was high in hospitals with only one registered procedure code. The quality of data can to some extent be checked on the basis of DRG coding (DRG group 468/477). Quality control of register data is required when the number in DRG 468/477 is high in the nation-wide register or when the number of specific procedures in hospitals is low.
In a retrospective study on diagnostic imaging of the stomach and large bowel, we evaluated the examination routines in six Norwegian hospitals for the period between 1975 and 1992. For both organ systems, a shift in routines from radiological examination toward endoscopy was observed. For the stomach there was a significant correlation between an increase in the use of endoscopy and a decrease in the use of X-ray examinations. Additionally, the total number of stomach examinations had declined. For the large bowel, the total number of endoscopic and radiological examinations had increased for all hospitals studied. While not as prominent as for the stomach, an obvious shift from X-ray examinations toward endoscopy was observed. These results should be considered when planning new imaging departments and hospitals in Norway.
Diagnostic imaging routines have changed rapidly during the last two decades. The real revolution started with the introduction of computed tomography into routine clinical work in the middle of the 1970s. Simultaneously, a tremendous sophistication of ultrasonography took place, and shortly later, magnetic resonance imaging started its "career." The present report explores how the introduction of computed tomography changed imaging routines in two major Norwegian hospitals during the last 10 to 15 years.
The unique pattern of peptic ulcer disease in arctic areas has long been of interest. Results from a retrospective study on the occurrences of gastric and duodenal ulcer for the period between 1962 and 1964 in the northern part of Norway are presented. These results are compared with preliminary data from an ongoing investigation of peptic ulcer in the radiological department at the University Hospital of Tromsø and with those presented by others from the same area in the 1940s. It is shown that the relation between gastric ulcer and duodenal ulcer has changed markedly both for women and men. However, there is still a higher incidence rate of gastric ulcer than of duodenal ulcer in women, whereas the ratio of gastric to duodenal ulcer in men is 1:1. These results contrast sharply with those reported elsewhere in Europe and in the United States.
The procedures used for imaging of the gastrointestinal tract, the gall bladder and the bile ducts were registered in six Norwegian hospitals during the period 1975-90. Data obtained from all hospitals showed a significant decrease in radiological examinations of the stomach and the large bowel, and a dramatic decrease of such examinations in the case of the gall bladder and bile ducts. The changes are mainly due to the increasing use of newer methods such as ultrasonography, gastroscopy and colonoscopy. The shift in the pattern of examinations, as shown in the present study, may well have many implications for patients and for the health service as a whole.
The roles of liver scintigraphy in addition to other imaging modalities of the esophagus and the small bowel and the use of abdominal flat films were studied in six Norwegian hospitals between 1975 and 1993. Parallel to the introduction of ultrasonography, the use of liver scintigraphy disappeared almost completely. Barium studies of the esophagus, to some degree, have been replaced by endoscopy, whereas use of barium studies of the small bowel remained unchanged or increased. The number of flat-film studies of the abdomen performed remained unchanged.
From a prospective epidemiological study of peptic ulcer disease in the northern part of Norway, incidence rates for gastric and duodenal ulcer are presented. Over a 3-year period 4234 patients were examined radiologically or endoscopically. The population at risk was 72,537 persons, 16 to 93 years old. The yearly incidence rate for gastric ulcer in women was 0.9 per 1000 and for men 1.4 per 1000. For duodenal ulcer the incidence rates were 0.8 and 1.5 per 1000, respectively. The ratio of gastric ulcer to duodenal ulcer is still 1 to 1.1 for both sexes, 1 to 0.9 in women, and 1 to 1.14 in men in the northern part of Norway. Furthermore, the present study indicates a statistically significant positive correlation between increasing age and the occurrence of peptic ulcers for both sexes.
From a prospective epidemiological and radiological study of peptic ulcer disease in the northern part of Norway, relations between occupation and the occurrence of new peptic ulcers are presented. Over a 3-year period 1861 patients with dyspeptic complaints, 557 women and 1304 men belonging to 12 different occupational groups, were studied. Special attention was paid to the fishing population, constituting 2488 men and only 55 women. In the period studied 87 gastric ulcers and 118 duodenal ulcers were found. A statistically significantly higher incidence of both gastric and duodenal ulcers was found in fishermen than in the other groups. Furthermore, significantly higher incidences of duodenal ulcers were found in men occupied in 'land or water transport'. Compared with the total male population at risk in the area studied, significantly higher incidences were found for duodenal ulcer in fishermen. The present study confirms prior reports both from Scotland and from North Norway, showing an increased incidence of peptic ulcers in the fishing population.
Intravenous urography (IU) was performed in 489 patients aged 0-9 years during 1980-1983. A total of 35 (7.2%), 19 (13.1%) boys and 16 (4.7%) girls had pathological changes at IU. Of these, 11 boys and 5 girls had findings with therapeutic consequences. We have analysed the results of IU and voiding cystoureterography (VC) in 62 patients and show that a normal IU does not exclude vesicoureteral reflux into the renal pelvis. By performing only VC hydronephrosis, pyelonephritic scarring and anomalies may be missed.
This report derives from Tromsoe in northern Norway. In a retrospective study of the indications for intravenous urography (IU) and the findings at IU in 740 patients (451 girls and 289 boys) aged 0-19 years, we found that urinary tract infections accounted for 69.4% of the IU in females 30.1% of the IU in males, most often seen in the youngest patients. The pathological findings most frequently seen were anomalies (17 females and 10 males) and urinary tract obstruction (3 females and 15 males). The present study indicates the following: first, that the yield of IU in the primary investigation of children and youth suffering from enuresis and non-specific abdominal disturbancies is small; and second, that the use of IU in children and youth with urinary tract infection and haematuria should be questioned and reconsidered.