| Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998-2007. | |
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MedLine Citation:
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PMID: 20924012 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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CONTEXT: Excessive use of medical imaging increases health care costs and exposure to ionizing radiation (a potential carcinogen) without yielding significant benefits to all patients. OBJECTIVE: To determine whether there has been a change in the prevalence of emergency department visits for injury-related conditions for which computed tomography (CT) or magnetic resonance imaging (MRI) was obtained and whether there has been a change in the diagnosis of life-threatening conditions and patient disposition. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cross-sectional analysis of emergency department visits using data from the National Hospital Ambulatory Medical Care Survey (1998-2007). Sampled visits were weighted to produce estimates for the United States. MAIN OUTCOMES MEASURES: Proportion of visits for injury-related conditions during which a CT or MRI was obtained, a life-threatening condition was diagnosed (eg, cervical spine fracture, skull fracture, intracranial bleeding, liver and spleen laceration), and which resulted in hospital and intensive care unit admission. RESULTS: The prevalence of CT or MRI use during emergency department visits for injury-related conditions increased from 6% (95% confidence interval [CI], 5%-7%) (257 of 5237 visits) in 1998 to 15% (95% CI, 14%-17%) (981 of 6567 visits) in 2007 (P < .001 for trend). There was a small increase in the prevalence of life-threatening conditions (1.7% [95% CI, 1.2%-2.2%; 89 of 5237 visits] in 1998 and 2.0% [95% CI, 1.6%-2.5%; 142 of 6567 visits] in 2007; P=.04 for trend) [corrected].There was no change in prevalence of visits during which patients were either admitted to the hospital (5.9% [95% CI, 4.9%-6.9%] in 1998 and 5.5% [95% CI, 4.7%-6.5%] in 2007; P = .50 for trend) or to an intensive care unit (0.62% [95% CI, 0.40%-1.00%] in 1998 and 0.80% [95% CI, 0.53%-1.21%] in 2007; P = .14 for trend). Visits during which CT or MRI was obtained lasted 126 minutes (95% CI, 123-131 minutes) longer than those for which CT or MRI was not obtained. CONCLUSION: From 1998 to 2007, the prevalence of CT or MRI use during emergency department visits for injury-related conditions increased significantly, without an equal increase in the prevalence of life-threatening conditions. |
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Authors:
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Frederick Kofi Korley; Julius Cuong Pham; Thomas Dean Kirsch |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: JAMA : the journal of the American Medical Association Volume: 304 ISSN: 1538-3598 ISO Abbreviation: JAMA Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-06 Completed Date: 2010-10-08 Revised Date: 2011-01-12 |
Medline Journal Info:
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Nlm Unique ID: 7501160 Medline TA: JAMA Country: United States |
Other Details:
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Languages: eng Pagination: 1465-71 Citation Subset: AIM; IM |
Affiliation:
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Department of Emergency Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. fkorley1@jhmi.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Child, Preschool Critical Illness / epidemiology Cross-Sectional Studies Decision Support Systems, Clinical Emergency Service, Hospital / statistics & numerical data* Female Health Care Costs Humans Infant Intensive Care Units / utilization Magnetic Resonance Imaging / economics, utilization* Male Middle Aged Patient Admission / statistics & numerical data Prevalence Retrospective Studies Tomography, X-Ray Computed / economics, utilization* United States / epidemiology Wounds and Injuries / epidemiology*, pathology, radiography* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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5KL2RR025006/RR/NCRR NIH HHS |
| Comments/Corrections | |
Comment In:
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JAMA. 2011 Jan 12;305(2):148-9; author reply 149
[PMID:
21224454
]
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Erratum In:
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JAMA. 2010 Nov 3;304(17):1901 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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