caa a22 4500 606171517 CHVBK 20210128100723.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10140-014-1265-6 doi (NATIONALLICENCE)springer-10.1007/s10140-014-1265-6 Variation in the utilization and positivity rates of CT pulmonary angiography among emergency physicians at a tertiary academic emergency department [Elektronische Daten] [Yingming Chen, Bruce G. Gray, Glen Bandiera, David MacKinnon, Djeven Deva] We examined the patient and physician characteristics related to the use and yield of computed tomography pulmonary angiogram (CTPA) for the diagnosis of pulmonary embolism (PE) at a tertiary academic hospital emergency department (ED). A cross-sectional retrospective study was conducted on 835 consecutive ED patients with suspected PE who underwent CTPA. Radiology report data were extracted from our institution's RIS PACS software (Syngo Imaging, Siemens) based on a targeted search of all CTPA reports from 2010 to 2012. Utilization and PE positivity rates of CTPA were calculated and correlated with patient characteristics including age and gender, as well as emergency physician (EP) characteristics including gender, years in practice, and training certification. Acute PE was diagnosed in 17.8% of patients. A further 32.9% of the scans were negative for PE but had other clinically significant findings. We found higher utilization rates in female and older patients (p < 0.001), however, without corresponding differences in PE positivity rates compared to their male and younger counterparts. There was a high inter-physician variation in CTPA utilization rate (range 0.21-0.77 scans per 100 patients seen) and PE positivity rate (range 6.7-38.9%). However, neither rates correlated with EP years of experience (p > 0.15 with cut-offs at 5, 10, and 20years post-residency), gender (p = 0.59), or training certification (p = 0.56 between EPs certified by the 5-year program of the Royal College of Physicians of Canada versus the 3-year program of the College of Family Physicians of Canada). Our study demonstrated considerable inter-physician variability in the utilization and PE positivity rates of CTPA. These results suggest an opportunity for a more standardized approach to the use of CTPA among EPs at our institution. American Society of Emergency Radiology, 2014 CT pulmonary angiogram nationallicence Pulmonary embolism nationallicence Test utilization nationallicence Inter-physician variation nationallicence Chen Yingming Department of Medical Imaging, St. Michael's Hospital, 30 Bond Street, 3rd Floor Cardinal Carter Wing, M5B 1W8, Toronto, Ontario, Canada aut Gray Bruce G. Department of Medical Imaging, St. Michael's Hospital, 30 Bond Street, 3rd Floor Cardinal Carter Wing, M5B 1W8, Toronto, Ontario, Canada aut Bandiera Glen Department of Emergency Medicine, St. Michael's Hospital, Toronto, Ontario, Canada aut MacKinnon David Department of Emergency Medicine, St. Michael's Hospital, Toronto, Ontario, Canada aut Deva Djeven Department of Medical Imaging, St. Michael's Hospital, 30 Bond Street, 3rd Floor Cardinal Carter Wing, M5B 1W8, Toronto, Ontario, Canada aut Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 221-229 1070-3004 22:3<221 2015 22 10140 https://doi.org/10.1007/s10140-014-1265-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-014-1265-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chen Yingming Department of Medical Imaging, St. Michael's Hospital, 30 Bond Street, 3rd Floor Cardinal Carter Wing, M5B 1W8, Toronto, Ontario, Canada aut NATIONALLICENCE 700 1- Gray Bruce G. Department of Medical Imaging, St. Michael's Hospital, 30 Bond Street, 3rd Floor Cardinal Carter Wing, M5B 1W8, Toronto, Ontario, Canada aut NATIONALLICENCE 700 1- Bandiera Glen Department of Emergency Medicine, St. Michael's Hospital, Toronto, Ontario, Canada aut NATIONALLICENCE 700 1- MacKinnon David Department of Emergency Medicine, St. Michael's Hospital, Toronto, Ontario, Canada aut NATIONALLICENCE 700 1- Deva Djeven Department of Medical Imaging, St. Michael's Hospital, 30 Bond Street, 3rd Floor Cardinal Carter Wing, M5B 1W8, Toronto, Ontario, Canada aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 221-229 1070-3004 22:3<221 2015 22 10140