The purpose of this prospective, multicenter, observational study was to determine how computed tomography (CT) affects the diagnosis, diagnosis, and clinical management decisions of emergency physicians.
Physicians from major academic medical centers were surveyed using diagnostic results before and after CT from July 2012 to February 2014. The reasons for using CT are headache, chest pain and/or difficulty breathing, abdominal pain. The survey involved 1,280 patients with 245 doctors. The results of the diagnosis before and after CT occurred in 24%, 42%, and 51% of patients with headache, chest pain, and/or dyspnea, and abdominal pain, respectively.
When the CT information is obtained, the diagnostic credibility increases significantly. CT information also changed the decision of patients to be hospitalized, with 19%, 19%, and 25%, respectively. The authors mention that CT has a large impact on the diagnosis, diagnostic credibility, and hospitalization decisions of emergency doctors.
expert's point:
This is an interesting study that attempts to quantify the efficacy of the emergency department using CT for diagnosis and decision making, taking into account the increased costs, ray bursts and scan-related incidental findings.
To compensate for the evidence gap, the authors prospectively observed the emergency department of Massachusetts General Hospital, Manchester University, Hopkins Hospital, Maryland Hospital, Duke University Medical Center, North Carolina Hospital, and Washington University.
This study showed that, overall, CT affected the primary diagnosis of 25%-50% of patients, and hospitalization decisions of 20%-25% of patients. There is indeed a large proportion of patients, and the results of diagnosis at local hospitals apply to medical centers across the country.
The authors provide a reasonable summary of the limitations of this study. This result argues that CT has a major role in the emergency department, but additional investigations are needed to balance the efficacy and potential risk of low-equivalent CT scans, radiation exposure and cost.
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