ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2018
Patient Preferences for Diagnostic Testing in the Emergency Department: A Cross-sectional Study.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- 'Communication Is Crucial': A Qualitative Study of Patient Expectations of Diagnostic Tests in Emergency Medicine Practice.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Subtle Differences in Physician Communication and Substantial Impacts on Patient Decision-Making About Low-Value Care: An Experimental Vignette Study.Journal of evaluation in clinical practice · 2025Article
- Implementing strategies to reduce the number of urgent low-value cranial CT for non-trauma reasons-where do we start fighting the hydra?European radiology · 2024Article
- Patient Preferences in Diagnostic Imaging: A Scoping Review.The patient · 2023Article
- ASNC's thoughts on the AHA/ACC chest pain guidelines.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- A Policy Statement on Cardiovascular Test Substitution and Authorization: Principles of Patient-Centered Noninvasive Testing.Journal of the American College of Cardiology · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundDiagnostic testing is common during emergency department (ED) visits. Little is understood about patient preferences for such testing. We hypothesized that a patient's willingness to undergo diagnostic testing is influenced by the potential benefit, risk, and personal cost.
methodsWe conducted a cross sectional survey among ED patients for diagnostic testing in two hypothetical scenarios: chest pain (CP) and mild traumatic brain injury (mTBI). Each scenario defined specific risks, benefits, and costs of testing. The odds of a participant desiring diagnostic testing were calculated using a series of nested multivariable logistic regression models.
resultsParticipants opted for diagnostic testing 68.2% of the time, including 69.7% of CP and 66.7% of all mTBI scenarios. In the CP scenario, 81% of participants desired free testing versus 59% when it was associated with a $100 copay (difference = 22%, 95% confidence interval [CI] = 16% to 28%). Similarly, in the mTBI scenario, 73% of adult participants desired free testing versus 56% when charged a $100 copayment (difference = 17%, 95% CI = 11% to 24%). Benefit and risk had mixed effects across the scenarios. In fully adjusted models, the association between cost and desire for testing persisted in the CP (odds ratio [OR] = 0.33, 95% CI = 0.23 to 0.47) and adult mTBI (OR = 0.47, 95% CI = 0.33 to 0.67) scenarios.
conclusionsIn this ED-based study, patient preferences for diagnostic testing differed significantly across levels of risk, benefit, and cost of diagnostic testing. Cost was the strongest and most consistent factor associated with decreased desire for testing.
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