| Frequency of use of imaging tests in the diagnosis of pulmonary embolism: effects of physician specialty, patient characteristics, and region. | |
| | |
MedLine Citation:
|
PMID: 20308505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: The purpose of this study was to ascertain whether clinical practice in diagnosing pulmonary embolism is consistent with recommendations in the literature and to explore variations in practice across site of care (e.g., emergency department), physician and patient characteristics, and geographic location. MATERIALS AND METHODS: Medicare 5% research identifiable files were analyzed. The cases of patients with emergency department visits or inpatient stays for a diagnosis of pulmonary embolism or for symptoms related to pulmonary embolism (shortness of breath, chest pain, and syncope) were identified. We determined the number of patients who underwent each type of relevant imaging test and evaluated variations in the first non-chest-radiographic test by site of care and treating physician specialty. Using logistic regression, we studied variations in the use of common imaging tests, exploring variations associated with patient characteristics, physician specialty, site of care, and geographic location. RESULTS: For patients in whom pulmonary embolism might have been suspected, the most common tests were echocardiography (26% of the patients), CT or CT angiography of the chest (11%), cardiac perfusion study (6.9%), and duplex ultrasound (7.3%). For patients with an inpatient diagnosis of pulmonary embolism, the most common tests were chest CT or CT angiography (49%), duplex ultrasound (18%), echocardiography (10.9%), and ventilation-perfusion scintigraphy (10.9%). For patients for whom pulmonary embolism might have been suspected, many large variations were found in practice patterns among physician specialties and geographic locations. There were fewer variations among patients with the inpatient diagnosis of pulmonary embolism. CONCLUSION: Physician practice in the diagnosis of pulmonary embolism is broadly consistent with recommendations. However, variations by physician specialty and geographic location may be evidence of inappropriate imaging. |
| | |
Authors:
|
Mythreyi Bhargavan; Jonathan H Sunshine; Rebecca S Lewis; Saurabh Jha; Jean B Owen; Joyce Vializ |
Related Documents
:
|
17236735 - Can multislice ct alone rule out reliably pulmonary embolism? a prospective study. 7892655 - Pulmonary embolism in neurosurgical patients. 4073115 - Pulmonary thromboembolic disease--diagnosis, management and prevention. 3377625 - Fatal pulmonary emboli in hospitalized patients. an autopsy study. 18612455 - Spontaneous resolution of coronary artery pseudoaneurysm consequent to percutaneous int... 17947595 - Noninvasive detection of diffuse intracranial disease. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: AJR. American journal of roentgenology Volume: 194 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2010 Apr |
Date Detail:
|
Created Date: 2010-03-23 Completed Date: 2010-05-06 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
|
Languages: eng Pagination: 1018-26 Citation Subset: AIM; IM |
Affiliation:
|
American College of Radiology, 1891 Preston White Dr, Reston, VA 20191, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Diagnosis, Differential Diagnostic Imaging / utilization* Female Humans Logistic Models Male Medicine Physician's Practice Patterns / statistics & numerical data* Pulmonary Embolism / diagnosis* Sensitivity and Specificity United States |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Optimizing Detectability of Renal Pathology With MDCT: Protocols, Pearls, and Pitfalls.
Next Document: The educational and career impact of using medical students for triaging off-hour diagnostic imaging...