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Author Levine, Matthew B. ♦ Moore, Andrew B. ♦ Franck, Chris ♦ Li, Jie ♦ Kuehl, Damon R.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Diagnosis ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Emergency ♦ Discipline Medicine ♦ Physician's Practice Patterns ♦ Statistics & Numerical Data ♦ Tomography, X-ray Computed ♦ Utilization ♦ Trauma Centers ♦ Adolescent ♦ Adult ♦ Aged ♦ Aged, 80 And Over ♦ Child ♦ Cross-sectional Studies ♦ Female ♦ Hospital Bed Capacity, 500 And Over ♦ Humans ♦ Logistic Models ♦ Male ♦ Middle Aged ♦ Retrospective Studies ♦ Tertiary Care Centers ♦ Young Adult ♦ Journal Article
Abstract STUDY OBJECTIVES: Variation in computed tomography (CT) use between emergency medicine (EM) physicians may delineate appropriate or inappropriate use. We hypothesize that variation in all types of CT use exists between providers and their use in patients with common chief concerns. We determine EM physicians' variability in CT use of all types and whether high use in one area predicts use of other CT types. METHODS: This was a retrospective study of EM physicians practicing at an 800-bed tertiary level 1 trauma center over a 3.5-year period. Computed tomography rates by type and by patient chief concern were modeled for providers as a function of patient acuity, disposition, age, and time of day using logistic regression. RESULTS: Of 195â 801 eligible visits, 44â 724 visits resulted in at least 1 CT scan. The adjusted rate of CT ordering by providers was 23.8% of patient visits, ranging from 11.5% to 32.7% The upper quartile of providers was responsible for 78% of the CT scans ordered above the mean. There was a large variation in use of all types of CT and by chief concern. There was an 8-fold variation in use of CT abdomen in discharged patients. High head CT use by providers predicts high use in all other CT types. CONCLUSION: We demonstrate a dramatic variation in CT use among EM physicians in all types of CT and common chief concerns. Greater variation was present in patients who were discharged. Large deviation from the mean by a group of providers may suggest inappropriate use.
Description Country affiliation: Vatican City
Author Affiliation: Levine MB ( Virginia Tech Carilion School of Medicine, Roanoke, VA.)
ISSN 07356757
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2013-10-01
Publisher Place United States
e-ISSN 15328171
Journal The American Journal of Emergency Medicine
Volume Number 31
Issue Number 10


Source: WHO-Global Index Medicus