Trends in Imaging for Suspected Pulmonary Embolism Across US Health Care Systems, 2004 to 2016.

JAMA Network Open
Ralph C WangRebecca Smith-Bindman

Abstract

In response to calls to reduce unnecessary diagnostic testing with computed tomographic pulmonary angiography (CTPA) for suspected pulmonary embolism (PE), there have been growing efforts to create and implement decision rules for PE testing. It is unclear if the use of advanced imaging tests for PE has diminished over time. To assess the use of advanced imaging tests, including chest computed tomography (CT) (ie, all chest CT except for CTPA), CTPA, and ventilation-perfusion (V/Q) scan, for PE from 2004 to 2016. Cohort study of adults by age group (18-64 years and ≥65 years) enrolled in 7 US integrated and mixed-model health care systems. Joinpoint regression analysis was used to identify years with statistically significant changes in imaging rates and to calculate average annual percentage change (growth) from 2004 to 2007, 2008 to 2011, and 2012 to 2016. Analyses were conducted between June 11, 2019, and March 18, 2020. Rates of chest CT, CTPA, and V/Q scan by year and age, as well as annual change in rates over time. Overall, 3.6 to 4.8 million enrollees were included each year of the study, for a total of 52 343 517 person-years of follow-up data. Adults aged 18 to 64 years accounted for 42 223 712 person-years (80.7%) an...Continue Reading

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Citations

Feb 17, 2021·Seminars in Respiratory and Critical Care Medicine·Delphine DouilletAndrea Penaloza
Feb 26, 2021·The American Journal of Medicine·Anne Gulbech OrdingTorben Bjerregaard Larsen
May 12, 2021·JAMA : the Journal of the American Medical Association·Alessandro N Franciosi, Cormac McCarthy
Jul 18, 2021·Journal of the American College of Radiology : JACR·Jarren K T TakakiHyo-Chun Yoon
Sep 23, 2021·Circulation. Cardiovascular Imaging·Michael K Atalay

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Software Mentioned

SAS
Joinpoint
YEARS
Joinpoint Regression Program

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