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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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A ROC (Receiver Operating Characteristic) plot is a graphical tool used to assess the performance of a binary classification model by illustrating the trade-off between sensitivity (true positive rate) and specificity (false positive rate). By plotting sensitivity against 1 - specificity across various threshold settings, the ROC curve shows how well the model distinguishes between classes, with a curve closer to the top-left corner indicating a more accurate model. The area under the ROC curve...
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Could Low-Value Diagnostic Tests be Compounding Access Block? A Single-Site, Cross-Sectional Study.

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This summary is machine-generated.

Nearly half of diagnostic tests in the emergency department (ED) were low-value, increasing wait times and reducing bed availability. Strategies are needed to reduce these tests and improve emergency care.

Keywords:
access blockdiagnostic testsemergency medicinelow‐value care

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Area of Science:

  • Emergency Medicine
  • Diagnostic Testing
  • Health Services Research

Background:

  • Low-value diagnostic tests contribute to healthcare costs and resource strain.
  • Optimizing diagnostic test utilization is crucial for efficient emergency department (ED) operations.

Purpose of the Study:

  • To determine the prevalence of low-value diagnostic tests in a major-referral ED.
  • To assess the impact of these tests on ED length of stay and bed availability.

Main Methods:

  • A cross-sectional study at Townsville University Hospital included adult patients undergoing 10 specified diagnostic tests.
  • Tests were classified as low-value based on Choosing Wisely recommendations using clinical documentation.
  • Emergency clinicians were blinded to the study's conduct.

Main Results:

  • 48.2% of all diagnostic tests (276/572) were classified as low-value.
  • Low-value laboratory tests comprised 50.6% (246/486), and low-value imaging tests were 24.4% (21/86).
  • Low-value imaging tests resulted in 152 lost bed-hours per 100 tests, impacting ED capacity.

Conclusions:

  • A significant proportion of diagnostic tests performed in the ED are of low value.
  • Low-value tests exacerbate ED access block, reduce bed availability, and delay emergency care.
  • Implementing evidence-based strategies is essential to reduce low-value testing and mitigate patient harm.