Publication Name	World Journal of Radiology
Manuscript ID	127912
DOI	10.4329/wjr.127912
Country	Türkiye

Category	Emergency Medicine
Manuscript Type	Opinion Review
Article Title	Defensive medicine and advanced imaging overuse in emergency departments: A focused review of imaging stewardship and overcrowding
Manuscript Source	Invited Manuscript
All Author List	Emre Kudu, Naz Hizli, Faruk Danış and Mustafa Altun
Funding Agency and Grant Number
Corresponding Author	Emre Kudu, Associate Professor, MD, Researcher, Department of Emergency Medicine, Marmara University School of Medicine, Muhsin Yazıcıoğlu Caddesi No. 10, İstanbul 34899, Türkiye. ekudu@marmara.edu.tr
Key Words	Defensive medicine; Emergency service, hospital; Diagnostic imaging; Tomography, X-ray computed; Magnetic resonance imaging; Medical overuse; Decision support systems, clinical; Crowding
Core Tip	Advanced imaging overuse in emergency departments is driven by diagnostic uncertainty, time pressure, malpractice concerns, patient expectations, consultant requests, and system-level workflow constraints. This narrative review synthesizes current evidence linking defensive medicine and low-value imaging to radiology bottlenecks, prolonged emergency department throughput, unnecessary costs, incidental findings, and clinician workload. It also proposes a conceptual reciprocal-pressure framework, in which crowding and defensive imaging reinforce each other, that has not been tested experimentally. It also summarizes reported mitigation strategies, including clinical decision rules, computerized clinical decision support, Choosing Wisely initiatives, shared decision-making, audit and feedback, and multidisciplinary imaging stewardship.
Citation	Kudu E, Hizli N, Danış F, Altun M. Defensive medicine and advanced imaging overuse in emergency departments: A focused review of imaging stewardship and overcrowding. World J Radiol 2026; In press DOI: https://doi.org/10.4329/wjr.127912
PDF	127912-in-press.pdf

Received	2026-09-10 02:06
Peer-Review Started	2026-09-10 02:07
First Decision by Editorial Office Director
Return for Revision	2026-09-23 07:02
Revised	2026-09-26 17:56
Publication Fee Transferred
Second Decision by Editor	2026-10-12 03:05
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-10-12 10:16
Articles in Press	2026-10-12 10:16
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8470 (online)
Open Access	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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