Ethnicity as an independent predictive factor for the results of computed tomography pulmonary angiography and ultrasonography of the lower limbs

Abstract

Given the same pretest probability according to the Wells score, European patients had significantly higher positive rates of CTPA and ultrasonography of the lower limbs than non-European patients. Further prospective studies are required to confirm our findings and establish an appropriate pretest assessment tool for non-European patients.

Cultural competence and over‐investigation

“…We propose a simple explanation for the conclusions raised in the study by Liao et al 1 To us, it highlights the issue of cultural competence. This is an area that requires further attention and the Royal Australasian College of Physicians (RACP) has built this into its curriculum.…”

“…A simple explanation for the significant differences in positivity rates for the investigations (as reiterated in figures 2 and 4 by Liao et al 1 ) is over-investigation of non-Caucasian patients. Simply, non-Caucasians cannot communicate adequately to the treating doctor the nature of their chest pain or leg pain.…”

“…In desperation, the treating doctor requests furtherand sometimes unnecessaryimaging and/or other investigations. In fact, the resulting over-imagingand its consequenceswas discussed by Liao et al 1 Higher positive rates for CTPA and leg USS was found in 'European' patientsthis might actually, in fact, reflect lower rates in non-Europeans because positives were diluted by cases of over-investigation. It is known that diagnosis can be biased by altered linguistic cues.…”