Demonstrating the use of population level data to investigate trends in the rate, radiation dose and cost of Computed Tomography across clinical groups: Are there any areas of concern?
Autor: | Kamarova S; Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.; Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.; Nepean Blue Mountains Local Health District, New South Wales Health, Kingswood, New South Wales, Australia., Youens D; Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.; Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia., Ha NT; Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia., Bulsara M; Institute for Health Research, University of Notre Dame, Notre Dame, Western Australia, Australia.; School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia., Doust J; Australian Women and Girls' Health Research (AWaGHR) Centre, School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Fox R; Division of Internal Medicine, Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia., Kritz M; Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia., McRobbie D; School of Physical Sciences, University of Adelaide, Adelaide, South Australia, Australia., O'Leary P; Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.; Obstetrics and Gynaecology Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia.; PathWest Laboratory Medicine, QE2 Medical Centre, Nedlands, Western Australia, Australia., Parizel PM; Medical School, University of Western Australia, Perth, Western Australia, Australia.; Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia., Slavotinek J; SA Medical Imaging, SA Health and College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia., Wright C; Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.; Division of Internal Medicine, Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia.; Fiona Stanley Hospital, Murdoch, Western Australia, Australia.; School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia., Moorin R; Health Economics and Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.; School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia. |
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Jazyk: | angličtina |
Zdroj: | Journal of medical radiation sciences [J Med Radiat Sci] 2024 Jul 09. Date of Electronic Publication: 2024 Jul 09. |
DOI: | 10.1002/jmrs.811 |
Abstrakt: | Introduction: Increases in computed tomography (CT) use may not always reflect clinical need or improve outcomes. This study aimed to demonstrate how population level data can be used to identify variations in care between patient groups, by analysing system-level changes in CT use around the diagnosis of new conditions. Methods: Retrospective repeated cross-sectional observational study using West Australian linked administrative records, including 504,723 adults diagnosed with different conditions in 2006, 2012 and 2015. For 90 days pre/post diagnosis, CT use (any and 2+ scans), effective dose (mSv), lifetime attributable risk (LAR) of cancer incidence and mortality from CT, and costs were assessed. Results: CT use increased from 209.4 per 1000 new diagnoses in 2006 to 258.0 in 2015; increases were observed for all conditions except neoplasms. Healthcare system costs increased for all conditions but neoplasms and mental disorders. Effective dose increased substantially for respiratory (+2.5 mSv, +23.1%, P < 0.001) and circulatory conditions (+2.1 mSv, +15.4%, P < 0.001). The LAR of cancer incidence and mortality from CT increased for endocrine (incidence +23.4%, mortality +18.0%) and respiratory disorders (+21.7%, +23.3%). Mortality LAR increased for circulatory (+12.1%) and nervous system (+11.0%) disorders. The LAR of cancer incidence and mortality reduced for musculoskeletal system disorders, despite an increase in repeated CT in this group. Conclusions: Use and costs increased for most conditions except neoplasms and mental and behavioural disorders. More strategic CT use may have occurred in musculoskeletal conditions, while use and radiation burden increased for respiratory, circulatory and nervous system conditions. Using this high-level approach we flag areas requiring deeper investigation into appropriateness and value of care. (© 2024 The Author(s). Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.) |
Databáze: | MEDLINE |
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