Evidence map›Paper›PMID 32651776›Full record

Observational studyLa Radiologia medica2021

Radiological outpatient' visits to avoid inappropriate cardiac CT examinations: an 8-year experience report.

Gianluca De Rubeis, Livia Marchitelli, Giulia Spano, Federica Catapano, Francesco Cilia, Nicola Galea, Iacopo Carbone, Carlo Catalano, Marco Francone

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in La Radiologia medica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 25% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. 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

9 authors at 2 institutions in 1 country.

Gianluca De RubeisDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy.ORCID http://orcid.org/0000-0002-9567-6710
Livia MarchitelliDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy.ORCID http://orcid.org/0000-0002-4159-7291
Giulia SpanoDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy.ORCID http://orcid.org/0000-0002-0595-6242
Federica CatapanoDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy.ORCID http://orcid.org/0000-0002-1004-5451
Francesco CiliaDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy.ORCID http://orcid.org/0000-0001-7675-0578
Nicola GaleaDepartment of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy.ORCID http://orcid.org/0000-0003-4708-5120
Iacopo CarboneDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy.ORCID http://orcid.org/0000-0003-3108-7527
Carlo CatalanoDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy.ORCID http://orcid.org/0000-0003-4208-9691
Marco FranconeDepartment of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, V.le Regina Elena, 324 00161, Rome, Italy. Marco.Francone@uniroma1.it.ORCID http://orcid.org/0000-0002-7906-3420
Sapienza University of Rome · ITCTO Hospital · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study was to evaluate the appropriateness of the cardiac computed tomography angiography (CCTA) prescriptions according to the "2010-Appropriate-Use-Criteria-for-Cardiac-Computed-Tomography-Angiography" (AUCCTA) and "Clinical-indication-for-CCTA" (CICCTA) among different specialities (Cardiologist [CA], General Practitioner [GP], Other Specialists [OS]) and prescribers' age. MATERIALS AND

methodsThis is a single-centre, single-arm, cohort study. We prospectively enrolled 815 patients (October 2012-May 2019) who underwent a radiological outpatient visit, before CCTA examination. Prescriptions to the examination were categorized as follows: Appropriate (A), Uncertain (U) and Inappropriate (Ina), according to AUCCTA and I, II, III and Inv for CICCTA. This categorization was stratified according to CA, GP and OS and prescribers' age. CCTA was performed in patients whom indications belong to A/U categories.

resultsEight hundred and fifteen CCTA prescriptions were analysed. An yearly increase in prescriptions was found in the eight-year observational period (2012/2019 projection: 72 vs 223). Considering AUCCTA, indication A was 540/815 (66.3%), indication U was 113/815 (13.9%) and Ina accounted for 162/815 (19.9%; 128/162 [79.0%] indications with stress test listed as criterium of inappropriateness). Only U indications decreased over years (p = 0.003). Regarding CICCTA, 501/815 (61.5%) patients were categorized as I, 144/815 (17.7%) as II, 102/815 (12.5%) as III, 67/815 (8.2%) were INV and 1/815 (0.1%) were non-classified. Clinical referrals were CA in 495/786 (63.0%), GPs in 57/786 (7.3%) GP and OS in 234/786 (29.8%) [p < 0.01]. No statistically significant differences were observed in the appropriateness among different specialty physicians. Younger doctors have a lower chance to not meet A indication (OR 0.98 [CI 95% 0.96-0.99]; p = 0.003).

conclusionOur study highlights the importance of a pre-radiological visit prior to CCTA, which prevented execution of 19.9% of inappropriate examinations. Age of prescribers had an impact on appropriateness, with younger doctors having a lower chance to not meet A indication.

Indexed as

OutpatientsUnnecessary ProceduresAgedComputed Tomography AngiographyCoronary AngiographyFemaleHumansMaleMiddle AgedPractice Patterns, Physicians'Retrospective StudiesComputed tomography angiographyGuideline adherenceOutpatient clinics, hospital

Identifiers

PMID32651776
OpenAlexW3041060502

What OpenQuestion holds

Textmetadata
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.