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Decision support system translates into high percentage of positive chest CT examinations

Using a decision support system for ordering chest CT examinations translates into positive examinations three-quarters of the time, a new study shows.

The study, conducted at Massachusetts General Hospital in Boston, of 93,818 chest CT examinations done with the assistance of a decision support system, found that 76% of patients had a positive finding on their CT.

"Rising concerns about radiation risks, imaging growth and reimbursement costs has highlighted inappropriate imaging use," said Dr. Supriya Gupta, MD, one of the authors of the study. The decision support system provides a "utility score" for the test being ordered, said Dr. Gupta. When faced with low utility scores, referring physicians may choose to modify their imaging request, cancel the examination, order a different type of examination or proceed with the order. The study found that only 12% of the examinations with a low utility score translated into a positive finding, said Dr. Gupta. That compares to 87% for those with a high utility score, she said.

The study also reviewed utilization. Utilization was highest when abnormal chest radiography, shortness of breath or persistent cough was listed as the indication for performing chest CT, Dr. Gupta said.

The study will be presented on May 1 at the 2012 American Roentgen Ray Society Annual Meeting in Vancouver, Canada.


Contact: Samantha Schmidt
American Roentgen Ray Society

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