Timely access to computed tomography and magnetic resonance imaging as a determinant of clinical and health system outcomes in acute critical conditions: a scoping review.

Introduction: Acute critical conditions such as stroke, trauma, and sepsis represent a substantial global burden of mortality, disability, and healthcare costs. In this context, computed tomography and magnetic resonance imaging constitute critical infrastructure for timely clinical decision-making. However, delays in access to diagnostic imaging persist as structural bottlenecks in many healthcare systems, with potential impacts on clinical and economic outcomes. The existing evidence on this relationship remains fragmented and heterogeneous across conditions and healthcare settings. Methods: A scoping review will be conducted in accordance with the Joanna Briggs Institute guidance and reported following PRISMA-ScR. Studies involving adult populations that evaluate timely access to computed tomography and/or magnetic resonance imaging and its association with clinical and economic outcomes in stroke, trauma, and sepsis will be included. A systematic search will be performed in PubMed, Scopus, Web of Science, and ScienceDirect using MeSH terms, free-text terms, and Boolean operators. The search will be limited to studies published in English between January 2010 and February 2026, with full text available. Study selection will be conducted independently by two reviewers using Rayyan. Data extraction will be performed using a standardised Microsoft Excel matrix, and evidence synthesis will be descriptive and narrative, without formal assessment of risk of bias. Expected results: The review is expected to identify heterogeneous evidence demonstrating consistent associations between timely access to CT and MRI and improved clinical outcomes, particularly in terms of reduced mortality, disability, and complications, as well as favourable effects on costs, length of hospital stay, and resource utilisation. In addition, variability in metrics of diagnostic timeliness and relevant knowledge gaps (especially in low- and middle-income settings) are anticipated, allowing diagnostic imaging to be conceptualised as a structural determinant of clinical and economic outcomes at the health system level.