Are EDs Overusing Abdominal CT Exams?

A large study exploring the potential overuse of abdominal computed tomography (CT) scans in emergency departments (EDs) has shown that CT scans are not overused but are being used as they should be.

Abdominal CT is being used more often to diagnose appendicitis, renal colic, diverticulitis, and other diseases in EDs. The researchers reviewed 633 CT studies conducted over a six-month period in the emergency department at Massachusetts General Hospital (Boston, MA, USA). They reviewed patient records and requests for a CT scan by referring doctors to determine if there was a suspected diagnosis indicated before the CT scan. They found that two-thirds of the doctors had a suspected diagnosis before the scan, and 50-60% of the time, the CT scan confirmed the suspected diagnosis.

"This yield is just about right. If the yield had been higher, it would have indicated that a lot of CT examinations were being done even though the referring physician already had enough information to make a correct diagnosis. If the yield was much lower, it would have indicated that CT examinations were being ordered that weren't providing information needed by the referring physician,” explained co-author Susanna Lee, M.D.

About 30% of the time, there was no suspected diagnosis and in these cases, the CT scans were positive in 40% of cases. About 25% of the time, the CT scans indicated a diagnosis that was not even considered. The study was presented at the annual meeting of the American Roentgen Ray Society (ARRS) in San Diego (CA, USA).




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