Written informed consent for computed tomography of the abdomen/pelvis is associated with decreased CT utilization in low-risk emergency department patients

Lisa H. Merck, Laura A. Ward, Kimberly E. Applegate, Esther Choo, Douglas W. Lowery-North, Katherine L. Heilpern

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Introduction: The increasing rate of patient exposure to radiation from computerized tomography (CT) raises questions about appropriateness of utilization. There is no current standard to employ informed consent for CT (ICCT). Our study assessed the relationship between informed consent and CT utilization in emergency department (ED) patients. Methods: An observational multiphase before-after cohort study was completed from 4/2010-5/2011. We assessed CT utilization before and after (Time I/ Time II) the implementation of an informed consent protocol. Adult patients were included if they presented with symptoms of abdominal/pelvic pathology or completed ED CT. We excluded patients with pregnancy, trauma, or altered mental status. Data on history, exam, diagnostics, and disposition were collected via standard abstraction tool. We generated a multivariate logistic model via stepwise regression, to assess CT utilization across risk groups. Logistic models, stratified by risk, were generated to include study phase and a propensity score that controlled for potential confounders of CT utilization. Results: 7,684 patients met inclusion criteria. In PHASE 2, there was a 24% (95% CI [10-36%]) reduction in CT utilization in the low-risk patient group (p

Original languageEnglish (US)
Pages (from-to)1014-1024
Number of pages11
JournalWestern Journal of Emergency Medicine
Volume16
Issue number7
DOIs
Publication statusPublished - 2015
Externally publishedYes

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Keywords

  • Computerized tomography
  • CT scan
  • Emergency medicine
  • Ethics

ASJC Scopus subject areas

  • Emergency Medicine

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