Evidence map›Paper›PMID 29724625›Full record

Observational studyJournal of the American College of Radiology : JACR2018

Downstream Imaging Utilization After MR Angiography Versus CT Angiography for the Initial Evaluation of Pulmonary Embolism.

Michael D Repplinger, Rebecca L Bracken, Brian W Patterson, Manish N Shah, Michael S Pulia, John B Harringa, Mark L Schiebler, Scott K Nagle

Abstract readComparative StudyObservational Study
In one paragraph

Observational study in Journal of the American College of Radiology : JACR, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. 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

8 authors at 1 institution in 1 country.

Michael D RepplingerDepartment of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin; Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin. Electronic address: mdreppli@medicine.wisc.edu.
Rebecca L BrackenDepartment of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
Brian W PattersonDepartment of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
Manish N ShahDepartment of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
Michael S PuliaDepartment of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
John B HarringaDepartment of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
Mark L SchieblerDepartment of Radiology, University of Wisconsin-Madison, Madison, Wisconsin.
Scott K NagleDepartment of Radiology, University of Wisconsin-Madison, Madison, Wisconsin.
University of Wisconsin–Madison · US

Funding

University of Wisconsin Institute for Clinical and Translational ResearchUL1TR002373 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI ELIZABETH S BURNSIDE, Allan R. Brasier · 2017 to 2026
$75.9M
Institutional Clinical and Translational Science AwardUL1TR000427 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI DREZNER, MARC KENNETH · 2012 to 2016
$32.2M
Institutional Career Development CoreKL2TR002374 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI Bo Liu, Marin Leigh Schweizer · 2017 to 2026
$9.7M
Institutional Clinical and Translational Science AwardKL2TR000428 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI DREZNER, MARC KENNETH · 2012 to 2016
$6.2M
Mentoring and Research in Patient-Oriented Geriatric Emergency CareK24AG054560 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI SHAH, MANISH N · 2017 to 2021
$955k
Improving Antibiotic Stewardship During The Treatment of Skin and Soft Tissue Infections in The Emergency Department: A Human Factors and Systems Engineering ApproachK08HS024342 · AHRQ · UNIVERSITY OF WISCONSIN-MADISON · PI PULIA, MICHAEL SANTINO · 2016 to 2020
$801k
Preventing Future Falls among Older Adults Presenting to the Emergency DepartmentK08HS024558 · AHRQ · UNIVERSITY OF WISCONSIN-MADISON · PI PATTERSON, BRIAN W · 2016 to 2020
$792k
Identifying Barriers and Facilitators to the Implementation of Radiation-Free Imaging Protocols in the Emergency DepartmentK08DK111234 · NIDDK · UNIVERSITY OF WISCONSIN-MADISON · PI REPPLINGER, MICHAEL DEAN · 2016 to 2018
$488k
AHRQ HHS K08 HS024342AHRQ HHS K08 HS024558NCATS NIH HHS KL2 TR000428NCATS NIH HHS KL2 TR002374NCATS NIH HHS UL1 TR000427NCATS NIH HHS UL1 TR002373NIA NIH HHS K24 AG054560NIDDK NIH HHS K08 DK111234NIDDK NIH HHS L30 DK106864
6 · The paper itself

Abstract

objectiveTo compare the proportion of emergency department (ED) patients who undergo subsequent chest CT or MR within 1 year of an initially negative scan for pulmonary embolism (PE).

methodsThis single-center, retrospective, observational study examined the use of chest CT or MR for ED patients with MR angiography (MRA) negative for PE during April 2008 to March 2013. We compared the 1-year scan utilization for these cases to an age- and sex-matched cohort of patients who underwent CT angiography (CTA). We also calculated time to first follow-up scan and mean radiation dose in each arm. Trained data abstractors used a standardized protocol and electronic case report form to gather all outcomes of interest. Results are reported as means or proportions with their associated confidence intervals (CIs).

resultsIn all, 717 ED patients (430 MRAs and 287 CTAs) were included. At 1 year, the proportion undergoing subsequent imaging (MRA 16.7%, CTA 15.3%; difference = 1.4%, 95% CI 4.05%-6.86%) and time to first follow-up scan (difference = 13 days, 95% CI -22.69-48.7) did not differ between arms. Mean radiation dose per patient at 1 year was significantly higher in the CTA arm (9.82 mSv; 95% CI 9.12-10.53) compared with 2.92 mSv (95% CI 1.86-3.98) with MRA. Those with an index MRA were more likely to undergo subsequent MRAs (odds ratio 3.68; 95% CI 1.22-11.12) than those with an index CTA. However, in both arms, the majority (85%) of subsequent scans were CTAs.

conclusionsWhen comparing patients initially undergoing MRA versus CTA for the evaluation of PE, there was no difference in downstream chest CT or MR use at 1 year.

Indexed as

Computed Tomography AngiographyMagnetic Resonance AngiographyAdultArmContrast MediaEmergency Service, HospitalFemaleHumansMaleMeglumineOrganometallic CompoundsPulmonary EmbolismRadiation DosageRetrospective StudiesContrast Mediagadobenic acidMeglumineOrganometallic Compounds

Identifiers

PMID29724625
PMCPMC6207470
OpenAlexW2799837948

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.