Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 169 - 174 |
| Number of pages | 6 |
| Journal | Internal Medicine Journal |
| Volume | 43 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2013 |
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Implementation of a clinical prediction tool for pulmonary embolism diagnosis in a tertiary teaching hospital reduces the number of computed tomography pulmonary angiograms performed. / Ong, Chongweng; Malipatil, Vivek; Lavercombe, M; Teo, K G W; Coughlin, Paul Bernard; Leach, Deborah S; Spanger, Manfred; Thien, Francis.
In: Internal Medicine Journal, Vol. 43, No. 2, 2013, p. 169 - 174.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Implementation of a clinical prediction tool for pulmonary embolism diagnosis in a tertiary teaching hospital reduces the number of computed tomography pulmonary angiograms performed
AU - Ong, Chongweng
AU - Malipatil, Vivek
AU - Lavercombe, M
AU - Teo, K G W
AU - Coughlin, Paul Bernard
AU - Leach, Deborah S
AU - Spanger, Manfred
AU - Thien, Francis
PY - 2013
Y1 - 2013
N2 - To evaluate the effect of implementing the Wells score clinical prediction tool (CPT) on rationalising the use of computed tomography pulmonary angiography (CTPA) for diagnosing pulmonary embolism (PE). Methods: Within a tertiary teaching hospital, a retrospective study was conducted applying Wells score to all CTPA ordered in the first quarter of 2007. Subsequently, an algorithm including Wells score and d-dimer assay was developed to assist clinicians in rationalising their ordering of CTPA. A prospective study was performed from February to August 2009 to assess the impact of this algorithm. CTPA results, d-dimer levels, referral sources and dates were recorded. The number of CTPA performed over a 7-month period following implementation of the algorithm was compared with the same period during the previous year. PE prevalence within each risk category was compared with the published literature. Results: Three hundred and thirty-three patients were investigated with CTPA in the prospective study period. Two hundred and sixty-eight patients (80.4 of cases) had complete data. The prevalence of PE in the present study was 13.8 with 57 (21.2 ) patients stratified to low risk, 169 (63.0 ) to intermediate risk and 42 (15.6 ) to high risk. Subgroup prevalence was 8.8 , 11.8 and 23.8 respectively. Compared with the same period in 2008, 121 (26.6 ) less CTPA were performed. Conclusion: Institutional implementation of a clinical prediction tool into the decision-making process is feasible and significantly reduces the number of CTPA being performed, with substantial cost savings and patient benefits. ? 2012 The Authors. Internal Medicine Journal ? 2012 Royal Australasian College of Physicians
AB - To evaluate the effect of implementing the Wells score clinical prediction tool (CPT) on rationalising the use of computed tomography pulmonary angiography (CTPA) for diagnosing pulmonary embolism (PE). Methods: Within a tertiary teaching hospital, a retrospective study was conducted applying Wells score to all CTPA ordered in the first quarter of 2007. Subsequently, an algorithm including Wells score and d-dimer assay was developed to assist clinicians in rationalising their ordering of CTPA. A prospective study was performed from February to August 2009 to assess the impact of this algorithm. CTPA results, d-dimer levels, referral sources and dates were recorded. The number of CTPA performed over a 7-month period following implementation of the algorithm was compared with the same period during the previous year. PE prevalence within each risk category was compared with the published literature. Results: Three hundred and thirty-three patients were investigated with CTPA in the prospective study period. Two hundred and sixty-eight patients (80.4 of cases) had complete data. The prevalence of PE in the present study was 13.8 with 57 (21.2 ) patients stratified to low risk, 169 (63.0 ) to intermediate risk and 42 (15.6 ) to high risk. Subgroup prevalence was 8.8 , 11.8 and 23.8 respectively. Compared with the same period in 2008, 121 (26.6 ) less CTPA were performed. Conclusion: Institutional implementation of a clinical prediction tool into the decision-making process is feasible and significantly reduces the number of CTPA being performed, with substantial cost savings and patient benefits. ? 2012 The Authors. Internal Medicine Journal ? 2012 Royal Australasian College of Physicians
UR - http://onlinelibrary.wiley.com.ezproxy.lib.monash.edu.au/doi/10.1111/j.1445-5994.2012.02926.x/abstract;jsessionid=534C10BB94FA6DF4AC83A5D182411A85.f04
U2 - 10.1111/j.1445-5994.2012.02926.x
DO - 10.1111/j.1445-5994.2012.02926.x
M3 - Article
VL - 43
SP - 169
EP - 174
JO - Internal Medicine Journal
JF - Internal Medicine Journal
SN - 1444-0903
IS - 2
ER -