ArticleJournal of the American College of Radiology : JACR2020
Higher Imaging Yield When Clinical Decision Support Is Used.
Article in Journal of the American College of Radiology : JACR, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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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
13 citing papers in PubMed, 23 citations in OpenAlex.
- Nudging provider adoption of clinical decision support: study protocol for a stepped-wedge cluster randomized, hybrid type III trial of an electronic health record-agnostic pulmonary embolism risk tool.Implementation science : IS · 2026Article
- Overuse of imaging for pulmonary embolism in emergency departments: a systematic review and meta-analysis.International journal of emergency medicine · 2026Review
- Exploring Patterns of D-Dimer Assay Ordering at an Australian Rural Referral Hospital: A Retrospective Audit.Emergency medicine Australasia : EMA · 2026Article
- Potential Diagnostic Error for Emergency Conditions, Mortality, and Healthy Days at Home.JAMA network open · 2025Article
- Article
- Usability of a Human Factors-based Clinical Decision Support in the Emergency Department: Lessons Learned for Design and Implementation.Human factors · 2024Article
- Integrating Clinical Decision Support Into Electronic Health Record Systems Using a Novel Platform (EvidencePoint): Developmental Study.JMIR formative research · 2023Article
- Computed Tomography Angiography for Detection of Pulmonary Embolism in Western Australia Shows Increasing Use with Decreasing Diagnostic Yield.Journal of clinical medicine · 2023Article
- Nudging Health Care Providers' Adoption of Clinical Decision Support: Protocol for the User-Centered Development of a Behavioral Economics-Inspired Electronic Health Record Tool.JMIR research protocols · 2023Article
- Acceptance, Barriers, and Facilitators to Implementing Artificial Intelligence-Based Decision Support Systems in Emergency Departments: Quantitative and Qualitative Evaluation.JMIR formative research · 2022Article
- Automated Pulmonary Embolism Risk Assessment Using the Wells Criteria: Validation Study.JMIR formative research · 2022Article
- Diagnosing pulmonary thromboembolism: Concerns and controversies.Medical journal, Armed Forces India · 2022Review
- Barriers to the Use of Clinical Decision Support for the Evaluation of Pulmonary Embolism: Qualitative Interview Study.JMIR human factors · 2021Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveIncreased utilization of CT pulmonary angiography (CTPA) for the evaluation of pulmonary embolism has been associated with decreasing diagnostic yields and rising concerns about the harms of unnecessary testing. The objective of this study was to determine whether clinical decision support (CDS) use would be associated with increased imaging yields after controlling for selection bias.
methodsWe performed a retrospective cohort study in the emergency departments of two tertiary care hospitals of all CTPAs performed between August 2015 and September 2018. Providers ordering a CTPA are routed to an optional CDS tool, which allows them to use Wells' Criteria for pulmonary embolism. After propensity score matching, CTPA yield was calculated for the CDS-use and CDS-dismissal groups and stratified by provider type.
resultsA total of 7,367 CTPAs were ordered during the study period. Of those, providers used the CDS tool in 2,568 (35%) cases and did not use the tool in 4,799 (65%) of cases. After propensity score matching, CTPA yield was 11.99% in the CDS-use group and 8.70% in the CDS-dismissal group (P < .001). Attending physicians, residents, and physician assistant CDS users demonstrated a 56.5% (P = .006), 38.7% (P = .01), and 16.7% (P = .03) increased yield compared with those who dismissed the tool, respectively. DISCUSSION: Diagnostic yield was 38% higher for CTPAs when the provider used the CDS tool, after controlling for selection bias. Yields were higher for every provider type. Further research is needed to discover successful strategies to increase provider use of these important tools.
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Registered trials
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.