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Computed tomography (CT) is the preferred diagnostic imaging modality for ruling out pulmonary embolism (PE). There is a robust body of evidence supporting decision rules to guide physicians about CT use, and compelling evidence that variability in CT use inappropriately increases cost and decreases quality of care.
To assess CT utilization, test positivity, and patient and provider characteristics associated with variability in utilization, investigators retrospectively evaluated CT scans for 835 patients in one Canadian academic emergency department between 2010 and 2012. Results were as follows:
The positivity rate for acute PE was 18%.
In 33% of patients, scan results were negative for PE but positive for an alternative clinically signific…