CT Overused in Testing for Pulmonary Embolism

Many imaging tests undergone by patients with possible pulmonary embolism may not be needed, with as much as 32% of tests in an observational study being classified as “avoidable” according to a performance measure endorsed by the National Quality Forum. 

The measure uses the patient’s pretest Wells scores to assess the need for image testing, with scores below 2 as low-risk, 2-6 as intermediate, and above 6 as high.  It is intended to limit patient exposure to radiation, as well as high cost of care.

Researchers reviewed the records of 5,940 patients spanning 12 hospitals, 3,849 of which had an image test performed.  More than 50% of the patients who underwent image testing were labeled as low-risk, the study showed, listing the participants as hemodynamically stable. 

The study also argued that many of the patients, having undergone D-dimer testing previous to image testing, should not have had the subsequent image test. 

"The opportunity for improving the efficiency of imaging for suspected [pulmonary embolism] is large. Future work should focus on interventions to close this performance gap," researchers concluded.

-Michael Potts