News Flash: Abdominal Computed Tomography Results Influence Decision Making in the ED

An uncontrolled case series shows little more than that physicians often alter their initial diagnostic and disposition impressions during the course of an emergency department evaluation.

Physicians' extensive reliance on diagnostic imaging has been tempered by calls for more awareness of costs and the harm associated with cumulative doses of ionizing radiation. Researchers assessed whether physicians' diagnostic certainty and management decisions changed after results of abdominal computed tomography (CT) scanning were known. Treating physicians completed a structured questionnaire before and after CT scanning and other tests and procedures for 584 adult patients with nontraumatic abdominal pain who presented to an academic emergency department (ED) during 16 months.

After physicians obtained final CT reports, they changed their diagnosis for 49% of patients and changed their management plan for 42%. Physicians' diagnostic c…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education