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Research ArticleOriginal Research

Increased Emergency Department Computed Tomography Use for Common Chest Symptoms Without Clear Patient Benefits

Andrew S. Coco and David T. O'Gurek
The Journal of the American Board of Family Medicine January 2012, 25 (1) 33-41; DOI: https://doi.org/10.3122/jabfm.2012.01.110039
Andrew S. Coco
MD, MS
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David T. O'Gurek
MD
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  • Figure 1.
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    Figure 1.

    Comparison of the proportion of common chest (CC) symptom–related visits associated with computed tomography orders in US emergency departments between 1997 to 1999 and 2005 to 2007. P < .0001 for all comparisons. *Individual symptom totals do not total overall CC symptom–related visit total because some visits were associated with one than one CC symptom.

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    Figure 2.

    Trend in the proportion of common chest (CC) symptom–related visits associated with a computed tomography order in US emergency departments, 2005 to 2007. P < .001 for trend.

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    Figure 3.

    Comparison of proportion of diagnostic categories of CC symptom–related visits in US emergency departments between 1997 to 1999 and 2005 to 2007 (n = 17,098). Results have been adjusted for sex, age, race, insurance, and region.

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    Table 1.

    Characteristics of Common Chest Symptom-Related* Visits to United States Emergency Departments, 1997 to 1999 and 2005 to 2007 (n = 17,098)

    CharacteristicOverall Proportion of Visits (%)Proportion of Visits, 1997 to 1999 (n = 6,851) (%)Proportion of Visits, 2005 to 2007 (n = 10,247) (%)P
    Sex
        Female555456.17
        Male454644
    Age (years)
        15–44383739<.01
        45–64302833
        >65323529
    Race
        White767874.04
        Black212023
        Other323
    Insurance
        Private353633<.01
        Medicare313429
        Medicaid171320
        Self-pay/other171717
    Geographic region
        Northeast202119.65
        Midwest242622
        South383541
        West181818
    • ↵* Common chest symptoms are chest pain, shortness of breath, or labored breathing.

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    Table 2.

    Multivariate Logistic Regression Model Predicting Common Chest Symptom-Related* Visits Associated with a Computed Tomography Order in United States Emergency Departments, 1997 to 1999 and 2005 to 2007

    CharacteristicOdds Ratio† (95% CI) of a Computed Tomography Order
    Time period
        1997–19991.00 (–)
        2005–20076.41 (5.12 – 8.03)
    Sex
        Female1.00 (–)
        Male0.92 (0.80 – 1.07)
    Age (years)
        15–441.00 (–)
        45–641.09 (0.92 – 1.29)
        >651.30 (1.04 – 1.61)
    Race
        White1.00 (–)
        Black0.92 (0.77 – 1.11)
        Other0.73 (0.50 – 1.07)
    Health insurance
        Private1.00 (–)
        Medicare0.88 (0.70 – 1.10)
        Medicaid0.71 (0.57 – 0.88)
        Self-pay/other0.96 (0.77 – 1.19)
    Geographic region
        Northeast1.00 (–)
        Midwest1.24 (0.90 – 1.70)
        South0.99 (0.74 – 1.31)
        West1.51 (1.15 – 1.99)
    • ↵* Common chest symptoms are chest pain, shortness of breath, or labored breathing.

    • † Adjusted for all other variables in the table.

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The Journal of the American Board of Family     Medicine: 25 (1)
The Journal of the American Board of Family Medicine
Vol. 25, Issue 1
January-February 2012
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Increased Emergency Department Computed Tomography Use for Common Chest Symptoms Without Clear Patient Benefits
Andrew S. Coco, David T. O'Gurek
The Journal of the American Board of Family Medicine Jan 2012, 25 (1) 33-41; DOI: 10.3122/jabfm.2012.01.110039

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Increased Emergency Department Computed Tomography Use for Common Chest Symptoms Without Clear Patient Benefits
Andrew S. Coco, David T. O'Gurek
The Journal of the American Board of Family Medicine Jan 2012, 25 (1) 33-41; DOI: 10.3122/jabfm.2012.01.110039
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