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!
Scientists use nanoparticle-delivered gene therapy to inhibit blinding eye disease in rodents
08.07.2020 | Johns Hopkins Medicine
Deconstructing glioblastoma complexity reveals its pattern of development
08.07.2020 | McGill University
Biochemists at Martin Luther University Halle-Wittenberg (MLU) have used a standard electron cryo-microscope to achieve surprisingly good images that are on par with those taken by far more sophisticated equipment. They have succeeded in determining the structure of ferritin almost at the atomic level. Their results were published in the journal "PLOS ONE".
Electron cryo-microscopy has become increasingly important in recent years, especially in shedding light on protein structures. The developers of the new...
New insight into the spin behavior in an exotic state of matter puts us closer to next-generation spintronic devices
Aside from the deep understanding of the natural world that quantum physics theory offers, scientists worldwide are working tirelessly to bring forth a...
Kiel physics team observed extremely fast electronic changes in real time in a special material class
In physics, they are currently the subject of intensive research; in electronics, they could enable completely new functions. So-called topological materials...
Solar cells based on perovskite compounds could soon make electricity generation from sunlight even more efficient and cheaper. The laboratory efficiency of these perovskite solar cells already exceeds that of the well-known silicon solar cells. An international team led by Stefan Weber from the Max Planck Institute for Polymer Research (MPI-P) in Mainz has found microscopic structures in perovskite crystals that can guide the charge transport in the solar cell. Clever alignment of these "electron highways" could make perovskite solar cells even more powerful.
Solar cells convert sunlight into electricity. During this process, the electrons of the material inside the cell absorb the energy of the light....
Empa researchers have succeeded in applying aerogels to microelectronics: Aerogels based on cellulose nanofibers can effectively shield electromagnetic radiation over a wide frequency range – and they are unrivalled in terms of weight.
Electric motors and electronic devices generate electromagnetic fields that sometimes have to be shielded in order not to affect neighboring electronic...
07.07.2020 | Event News
02.07.2020 | Event News
19.05.2020 | Event News
13.07.2020 | Physics and Astronomy
13.07.2020 | Life Sciences
13.07.2020 | Life Sciences