The study was led by Pari Pandharipande, MD, director of the Massachusetts General Hospital Institute of Technology Assessment in Boston.
All total, 245 physicians completed both pre- and post-CT surveys for 1,280 patients in the study. The surveys revealed:
1. Physicians’ leading diagnoses and management decisions changed for more than half (51 percent) of patients who visited the ED with abdominal pain
2. Diagnoses changed for 42 percent of patients with chest pain or shortness of breath
3. The physicians of nearly a quarter (24 percent) of patients with a headache changed their care decisions after viewing CT scan results
4. The test results confirmed or ruled out alternative diagnoses in 95 to 97 percent of the cases
5. Overall, decisions about admitting patients to the hospital were changed 19 to 25 percent of the time post-CT scan
“[ED] physicians who face increasing pressure to make clinical decisions quickly are sometimes criticized for ordering too many CT scans that may not be clinically justified,” said Dr. Pandharipande. “We found that — for patients with abdominal pain, chest pain or shortness of breath, or with headache — physicians’ leading diagnoses and management decisions frequently changed after CT and that diagnostic uncertainty felt by physicians was alleviated.”
More articles on diagnostics:
5 thoughts from a co-author of the IOM ‘Improving Diagnosis in Health Care’ report
8 ways to estimate the incidence of diagnostic errors
IOM releases landmark report on improving diagnostics in healthcare: 5 key issues
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