患者摄影协会与放射科医生建议进行额外的成像
Jeffrey P Guenette1, Jungwun Lee2, Sebastien Haneuse3
1Director of Head and Neck Imaging and Interventions, Division of Neuroradiology and Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Journal of the American College of Radiology : JACR
|November 14, 2024
概括
在电子健康记录 (EHR) 中显示患者照片与更少的额外成像建议有关. 在头部和部放射学中观察到的这种关联似乎不受患者种族的影响.
科学领域:
- 放射学和医学成像学 医学成像学
- 医疗信息学 医疗信息学
- 健康 公平 研究 健康 公平 研究
背景情况:
- 患者照片越来越多地被整合到电子健康记录 (EHR) 中.
- 这些照片对放射学临床决策的潜在影响仍未得到充分探索.
- 了解影响额外成像 (RAI) 建议的因素对于优化患者护理途径至关重要.
研究的目的:
- 调查在EHR中患者照片的存在与在头部和部CT/MRI检查中收到额外成像 (RAI) 建议的可能性之间的关联.
- 确定自我报告的种族是否会改变患者照片和RAI之间的关系.
主要方法:
- 在多个机构进行了一项回顾性观察性研究,分析了2021年6月至2022年5月的头部和部CT/MRI报告.
- 混合效应模型被用来评估照片显示和RAI之间的关联,调整了诸如年龄,性别,复杂度得分,种族和区域剥夺指数等共变量.
- 种族被分析为一个交互术语,多次归算解决了缺失的种族数据.
主要成果:
- 这项研究包括了来自48,143名患者的60,543份报告. 照片出现在18.2%的报道中.
- 附带照片的报告显示,含有RAI的几率在统计学上显著下降 (OR:0.85,95%CI:0.77-0.93,P <.001).
- 在种族和关于RAI的照片存在之间没有发现显著的相互作用 (OR:0.99,95%CI:0.69-1.46,P = .97).
结论:
- 在EHR中有照片的患者接受额外成像推的可能性较低.
- 这种效应似乎不是由隐含的种族偏见驱动的,这表明患者个性化的潜在好处.
- 需要进行进一步的研究,以确定这种现象对医疗保健质量和患者结果的整体影响.
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