Rates of PE Diagnosis by CT Angiography When Clinical Decision Support Advice Is Overridden

Among patients with a low likelihood of pulmonary embolism, the rate of PE findings was 51% lower when providers ignored evidence-based decision-support prompts than when they followed them.

This study describes physician noncompliance with an evidence-based clinical decision support (CDS) tool for pulmonary embolism (PE) in a moderate-sized tertiary academic center. The rate of overriding CDS evidence-based protocols for low-risk PE was evaluated, along with the subsequent rate of positive findings by computed tomography (CT) angiography.

Low-risk patients were defined by a Wells score of ≤4. For these patients, a d-dimer assay was recommended for risk stratification. The rate of positive CT findings in patients who did not have a d-dimer ordered or who had a normal d-dimer but went on to CT angiography anyway (the override group; 589 patients) was compared with the rate in those who had CT angiography based on CDS (i.e., Wells…

Reviewing Author

Jennifer L. Wiler, MD, MBA, FACEP

Disclosures

Leadership Positions in Professional SocietiesColorado Medical Society (Member, Board of Directors)

Jennifer L. Wiler, MD, MBA, FACEP

Disclosures

Leadership Positions in Professional SocietiesColorado Medical Society (Member, Board of Directors)

Rates of PE Diagnosis by CT Angiography When Clinical Decision Support Advice Is Overridden

Topics

Reviewing Author