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Rise in CT Use in ED Curbs Admissions, Transfers

Cheryl Clark, for HealthLeaders Media, August 11, 2011

The researchers did not provide estimates of how much was saved in healthcare costs or bed days avoided.

CT imaging in the ED accounts for 25% of all CT scanning in the country, they found.

The authors recommend several next steps. For starters, they want more research to link particular patient complaints with the ED provider's choice to call for a CT.  They also want more effort to better delineate where use of CT results in better resource utilization and clinical outcomes.

But in an accompanying editorial, Robert Wears, MD, of the University of Florida Health Science Center, questions whether ED physicians are using CT scans too much, simply to be more certain of a diagnosis or to satisfy patients' demands that everything possible be done.

Wears's piece is entitled "The Hunting of the Snark," after the Lewis Carroll work about a group that pursues a mythic creature but meets its own doom in the process. "One is struck by the feeling that, in our quest for ever more perfect certainty, we are reenacting that famous tragedy."

"If physicians observe that many of their colleagues are using CT more liberally, it begins to seem at least okay and eventually may persuade them to join  the crowd because, after all, the 'standard of care' is that which most physicians do," Wears wrote.

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