The study is part of an effort by BWH researchers to develop strategies for achieving the appropriate use of expensive radiologic exams. They investigated 55,281 patient visits to an adult-only ED in 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 percent of the visits generated head CT examinations, and per-physician ordering rates ranged from 4.4 percent to 16.9 percent, suggesting a greater than two-fold variability in head CT use. Researchers did not find any significant correlation between physician age or gender and CT ordering, as described in previous studies.
The researchers concluded the variability may be due to physician’s practice style, knowledge gaps, risk tolerance or other factors. They are currently assessing whether real-time evidence-based clinical decision support will impact this variation.
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