ArticleEmergency radiology2015
Variation in the utilization and positivity rates of CT pulmonary angiography among emergency physicians at a tertiary academic emergency department.
Article in Emergency radiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Pooled it
- How Tasmanian Emergency Departments 'Choose Wisely' When Investigating Suspected Pulmonary Embolism.Healthcare (Basel, Switzerland) · 2023Article
- CTPA ordering trends in local emergency departments: are they increasing and did they increase as a result of COVID-19?Emergency radiology · 2023Article
- The impact of performance feedback reports on physician ordering behavior in the use of computed tomography pulmonary angiography (CTPA).Emergency radiology · 2023Article
- Pulmonary Embolism in Women: A Systematic Review of the Current Literature.Journal of cardiovascular development and disease · 2022Review
- Clinician Attitudes and Beliefs Associated with More Aggressive Diagnostic Testing.The American journal of medicine · 2022Article
- Use of Computed Tomography Pulmonary Angiography in Emergency Departments: A Literature Review.Healthcare (Basel, Switzerland) · 2022Review
- Feasibility of a quality improvement project to increase adherence to evidence-based pulmonary embolism diagnosis in the emergency department.Pilot and feasibility studies · 2021Article
- Predictors of positive computed tomography pulmonary angiography results.Emergency radiology · 2020Observational
- Variability in practice patterns among emergency physicians in the evaluation of patients with a suspected diagnosis of pulmonary embolism.Emergency radiology · 2020Article
- Predictors of Overtesting in Pulmonary Embolism Diagnosis.Academic radiology · 2020Article
- Awareness of relative CT utilization among peers is not associated with changes in imaging requests among emergency department providers in a large county hospital.Emergency radiology · 2020Article
- Risk orientation predicts hypoxic time during difficult airway simulation: a mixed-methods pilot study.BMJ simulation & technology enhanced learning · 2020Article
- Computed tomography for suspected pulmonary embolism results in a large number of non-significant incidental findings and follow-up investigations.Emergency radiology · 2019Article
- Analysis of Physician Variation in Provision of Low-Value Services.JAMA internal medicine · 2019Observational
- Association of Lower Diagnostic Yield With High Users of CT Pulmonary Angiogram.JAMA internal medicine · 2018Article
- The Association Between Physician Empathy and Variation in Imaging Use.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2016Article
- Observational
- Low Incidence of Symptomatic Thrombotic Events in Adult Patients Hospitalized with Coronavirus 19: A Retrospective Cohort Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We examined the patient and physician characteristics related to the use and yield of computed tomography pulmonary angiogram (CTPA) for the diagnosis of pulmonary embolism (PE) at a tertiary academic hospital emergency department (ED). A cross-sectional retrospective study was conducted on 835 consecutive ED patients with suspected PE who underwent CTPA. Radiology report data were extracted from our institution's RIS PACS software (Syngo Imaging, Siemens) based on a targeted search of all CTPA reports from 2010 to 2012. Utilization and PE positivity rates of CTPA were calculated and correlated with patient characteristics including age and gender, as well as emergency physician (EP) characteristics including gender, years in practice, and training certification. Acute PE was diagnosed in 17.8 % of patients. A further 32.9 % of the scans were negative for PE but had other clinically significant findings. We found higher utilization rates in female and older patients (p < 0.001), however, without corresponding differences in PE positivity rates compared to their male and younger counterparts. There was a high inter-physician variation in CTPA utilization rate (range 0.21-0.77 scans per 100 patients seen) and PE positivity rate (range 6.7-38.9 %). However, neither rates correlated with EP years of experience (p > 0.15 with cut-offs at 5, 10, and 20 years post-residency), gender (p = 0.59), or training certification (p = 0.56 between EPs certified by the 5-year program of the Royal College of Physicians of Canada versus the 3-year program of the College of Family Physicians of Canada). Our study demonstrated considerable inter-physician variability in the utilization and PE positivity rates of CTPA. These results suggest an opportunity for a more standardized approach to the use of CTPA among EPs at our institution.
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