Imaging has been identified as one of the key drivers of increased healthcare costs. A new study from Brigham and Women's Hospital and Harvard Medical School has found significant variation in the use of head computed tomography (CT), even within a single emergency department. Strategies to reduce such variation in head CT use may reduce cost and improve quality of care. The study appears online in advance of publication in the April issue of The American Journal of Medicine.
A recent measure approved by the Centers for Medicare and Medicaid is assessing variations in the use of head CT in patients with atraumatic headaches between hospitals nationwide. Researchers hypothesized that there is a significant variation in physician head CT use even within a single facility. "Even after accounting for a number of factors associated with ordering behavior, we found that greater than 2-fold variability in head CT use still persists," explains lead author Luciano M. Prevedello, MD, Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School.
The study looked at whether a head CT was performed in 55,281 patient visits to the adult-only emergency department at a large urban academic hospital throughout 2009. Patient variables included patient age, gender, severity of the emergency, emergency department location, and disease categorization. Physician-specific variables included years in practice and gender.
Overall, 8.9% of the visits generated head CT examinations. Rates per physician ranged from 4.4% to 16.9%. Patients receiving head CT were more likely to be male, older, and in a more urgent emergency category. Patients with head trauma were more likely to obtain a CT, followed by patients with stroke, headache, and other types of trauma. Contrary to earlier studies, the researchers found no significant correlation between physician age or gender and CT ordering.
"The variability may have been due to physician's practice style, knowledge gaps, risk tolerance, or other factors," says Dr. Prevedello. "We are currently investigating the impact of real-time evidence-based clinical decision support (embedded in the electronic health record) on variation in test ordering behavior of physicians to improve quality of care and improve appropriateness of testing.""Robert G. Stern, MD, Department of Radiology, University of Arizona College of Medicine, Tucson, a noted expert in the field comments, "Attempts to reduce utilization of expensive imaging studies have been made in the past, without any real focus on quality of care and appropriate ordering patterns. Dr. Prevedello and his colleagues underscore the need to develop evidence-based systems to reduce costly and inappropriate resource allocations."
Jane Grochowski | EurekAlert!
Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan
Prospect for more effective treatment of nerve pain
20.02.2017 | Universität Zürich
In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...
The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...
Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...
Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...
13.02.2017 | Event News
10.02.2017 | Event News
09.02.2017 | Event News
20.02.2017 | Materials Sciences
20.02.2017 | Health and Medicine
20.02.2017 | Health and Medicine