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Low-value testing can cause direct and indirect harm through overdiagnosis, false-positive results, and increased costs. Use of risk stratification tools (RSTs) should curtail low-value testing, but these tools are often ignored. To assess factors that contribute to physicians' decisions whether to use RSTs for pulmonary embolism (PE), researchers performed semi-structured interviews with 23 emergency physicians at 12 hospitals in New England. Physicians were asked about their approach to diagnosis, variations from their standard approach, use of RSTs for PE (including Pulmonary Embolism Rule-Out Criteria [PERC], Wells score, D-dimer testing), and barriers and facilitators to use of RSTs.
Participants (44% women) had a median 14 years of exp…