Evidence map›Paper›PMID 39002104›Full record

ArticleEmergency radiology2024

Longitudinal changes in the US emergency department use of advanced neuroimaging in the mechanical thrombectomy era.

Lauren E Mamer, Keith E Kocher, James A Cranford, Phillip A Scott

Abstract read
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In one paragraph

Article in Emergency radiology, 2024. 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.

Lauren E MamerDepartment of Emergency Medicine, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109-5301, USA. lmamer@med.umich.edu.ORCID http://orcid.org/0000-0002-7253-1340
Keith E KocherDepartment of Emergency Medicine, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109-5301, USA.
James A CranfordDepartment of Emergency Medicine, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109-5301, USA.
Phillip A ScottDepartment of Emergency Medicine, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109-5301, USA.

Funding

CTSA K12 Program at the University of MichiganK12TR004374 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI VICKI L ELLINGROD, Leah Elizabeth Robinson · 2023 to 2026
$6.5M
NCATS NIH HHS K12TR004374
6 · The paper itself

Abstract

purposeTo describe ED neuroimaging trends across the time-period spanning the early adoption of endovascular therapy for acute stroke (2013-2018). MATERIALS AND

methodsWe performed a retrospective, cross-sectional study of ED visits using the 2013-2018 National Emergency Department Sample, a 20% sample of ED encounters in the United States. Neuroimaging use was determined by Common Procedural Terminology (CPT) code for non-contrast head CT (NCCT), CT angiography head (CTA), CT perfusion (CTP), and MRI brain (MRI) in non-admitted ED patients. Data was analyzed according to sampling weights and imaging rates were calculated per 100,000 ED visits. Multivariate logistic regression analysis was performed to identify hospital-level factors associated with imaging utilization.

resultsStudy population comprised 571,935,906 weighted adult ED encounters. Image utilization increased between 2013 and 2018 for all modalities studied, although more pronounced in CTA (80.24/100,000 ED visits to 448.26/100,000 ED visits (p < 0.001)) and CTP (1.75/100,000 ED visits to 28.04/100,000 ED visits p < 0.001)). Regression analysis revealed that teaching hospitals were associated with higher odds of high CTA utilization (OR 1.88 for 2018, p < 0.05), while low-volume EDs and public hospitals showed the reverse (OR 0.39 in 2018, p < 0.05).

conclusionsWe identified substantial increases in overall neuroimaging use in a national sample of non-admitted emergency department encounters between 2013 and 2018 with variability in utilization according to both patient and hospital properties. Further investigation into the appropriateness of this imaging is required to ensure that access to acute stroke treatment is balanced against the timing and cost of over-imaging.

Indexed as

Emergency Service, HospitalNeuroimagingStrokeAdultAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesThrombectomyUnited StatesAdvanced neuroimagingCT angiogramCT perfusionMRIStroke

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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.