ArticleJournal of the American College of Radiology : JACR2024
CT Pulmonary Angiogram Clinical Pretest Probability Tool: Impact on Emergency Department Utilization.
Article in Journal of the American College of Radiology : JACR, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- AI-Based Pulmonary Embolism Detection: The Added Value of a False-Positive Reduction Module over a Region Proposal Network.Diagnostics (Basel, Switzerland) · 2026Article
- Clinical Decision Support: Point-Closing Gaps Between Evidence and Practice to Mitigate Diagnostic Error.AJR. American journal of roentgenology · 2026Article
- Article
- Impact of a Clinical Decision Support System on CT Pulmonary Angiography Yield and Utilization in Hospitalized Patients.Journal of the American College of Radiology : JACR · 2025Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
objectiveCurrently, CT pulmonary angiogram (CTPA) for evaluating acute pulmonary embolism (PE) in emergency departments (EDs) is overused and with low yields. The goal of this study is to assess the impact of an evidence-based clinical decision support (CDS) tool, aimed at optimizing appropriate use of CTPA for evaluating PE.
methodsThe study was performed at EDs in a large health care system and included nine academic and community hospitals. The primary outcome was the percent difference in utilization (number of CTPAs performed per number of ED visits) and secondary outcome was yield (percentage of CTPAs positive for acute PE), comparing 12 months before (June 1, 2021, to May 31, 2022) versus 12 months after (June 1, 2022, to May 31, 2023) a systemwide implementation of the CDS. Univariate and multivariable analyses using logistic regression were performed to assess factors associated with diagnosis of acute PE. Statistical process control charts were used to assess monthly trends in utilization and yield.
resultsAmong 931,677 visits to EDs, 28,101 CTPAs were performed on 24,675 patients. In all, 14,825 CTPAs were performed among 455,038 visits (3.26%) pre-intervention and 13,276 among 476,639 visits (2.79%) postintervention, a 14.51% relative decrease in CTPA utilization (χ DISCUSSION: Implementing a CDS based on validated decision rules was associated with a significant reduction in CTPA utilization. The change was immediate and sustained for 12 months postintervention.
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