Evidence map›Paper›PMID 28116030›Full record

ArticleThe western journal of emergency medicine2017

Can Emergency Medicine Residents Predict Cost of Diagnostic Testing?

Christopher R Tainter, Joshua A Gentges, Stephen H Thomas, Boyd D Burns

Abstract read
In one paragraph

Article in The western journal of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Christopher R TainterUniversity of California, San Diego, Department of Emergency Medicine and Department of Anesthesiology, Division of Critical Care, San Diego, California.
Joshua A GentgesThe University of Oklahoma, Tulsa, Department of Emergency Medicine, Tulsa, Oklahoma.
Stephen H ThomasWeill Cornell College of Medicine in Qatar and Hamad Medical Corporation, Department of Emergency Medicine, Doha, Qatar.
Boyd D BurnsThe University of Oklahoma, Tulsa, Department of Emergency Medicine, Tulsa, Oklahoma.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDiagnostic testing represents a significant portion of healthcare spending, and cost should be considered when ordering such tests. Needless and excessive spending may occur without an appreciation of the impact on the larger healthcare system. Knowledge regarding the cost of diagnostic testing among emergency medicine (EM) residents has not previously been studied.

methodsA survey was administered to 20 EM residents from a single ACGME-accredited three-year EM residency program, asking for an estimation of patient charges for 20 commonly ordered laboratory tests and seven radiological exams. We compared responses between residency classes to evaluate whether there was a difference based on level of training.

resultsThe survey completion rate was 100% (20/20 residents). We noted significant discrepancies between the median resident estimates and actual charge to patient for both laboratory and radiological exams. Nearly all responses were an underestimate of the actual cost. The group median underestimation for laboratory testing was $114, for radiographs $57, and for computed tomography exams was $1,058. There was improvement in accuracy with increasing level of training.

conclusionThis pilot study demonstrates that EM residents have a poor understanding of the charges burdening patients and health insurance providers. In order to make balanced decisions with regard to diagnostic testing, providers must appreciate these factors. Education regarding the cost of providing emergency care is a potential area for improvement of EM residency curricula, and warrants further attention and investigation.

Indexed as

Clinical CompetenceCurriculumDiagnostic Tests, RoutineEducation, Medical, GraduateEmergency MedicineHumansInternship and ResidencyPilot ProjectsSurveys and Questionnaires

Identifiers

PMID28116030
PMCPMC5226753

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.