Emergency Department Variation in Utilization and Diagnostic Yield of Advanced Radiography in Diagnosis of Pulmonary Embolus

Abstract Background There is growing pressure to measure and reduce unnecessary imaging in the emergency department. Objective We study provider and hospital variation in utilization and diagnostic yield for advanced radiography in diagnosis of pulmonary embolism (PE) and to assess patient- and prov...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of emergency medicine 2014-06, Vol.46 (6), p.791-799
Main Authors: Kindermann, Dana R., MD, MPH, McCarthy, Melissa L., ScD, Ding, Ru, MS, Frohna, William J., MD, Hansen, Jonathan, MD MBA, Maloy, Kevin, MD, Milzman, David P., MD, Pines, Jesse M., MD, MBA, MSCE
Format: Article
Language:English
Subjects:
Adult
African Americans
Age Factors
Chest Pain - etiology
Clinical Competence
diagnostic yield
Dyspnea - etiology
Emergency
Emergency Medicine - education
Emergency Service, Hospital - statistics & numerical data
Female
Hospitals - statistics & numerical data
Humans
imaging
Internship and Residency
Male
Middle Aged
Practice Patterns, Physicians' - statistics & numerical data
Pulmonary Embolism - complications
Pulmonary Embolism - diagnostic imaging
Radionuclide Imaging - utilization
resource utilization
Retrospective Studies
Sex Factors
Tomography, X-Ray Computed - utilization
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background There is growing pressure to measure and reduce unnecessary imaging in the emergency department. Objective We study provider and hospital variation in utilization and diagnostic yield for advanced radiography in diagnosis of pulmonary embolism (PE) and to assess patient- and provider-level factors associated with diagnostic yield. Methods Retrospective chart review of all adult patients presenting to four hospitals from January 2006 through December 2009 who had a computed tomography or ventilation/perfusion scan to evaluate for PE. Demographic data on the providers ordering the scans were collected. Diagnostic yield (positive scans/total scans ordered) was calculated at the hospital and provider level. The study was not designed to assess appropriateness of imaging. Results There was significant variation in utilization and diagnostic yield at the hospital level (chi-squared, p  
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2013.12.002