Implications of language barrier on the diagnostic yield of computed tomography in pulmonary embolism

Stowell, Jeffrey R.; Filler, Levi; Sabir, Marya S.; Roh, Albert T.; Akhter, Murtaza

doi:10.1016/j.ajem.2017.12.056

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…The lower risks of adverse events and in-hospital death observed among patients receiving language-concordant care may partially be explained by enhanced patient-provider communication (e.g., ability to elicit symptoms and obtain a complete medical history), which can improve the accuracy and timeliness of diagnoses made by physicians. 37,38 Physicians who cannot effectively communicate with their patients are more likely to perform additional (and sometimes unnecessary) investigations, 39,40 which could result in an increased risk of adverse events and prolonged stays in hospital. Clear and effective patient-provider communication also has the potential to improve patient cooperation and engagement, which is associated with positive health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Patient–physician language concordance and quality and safety outcomes among frail home care recipients admitted to hospital in Ontario, Canada

Seale

Reaume

Batista

et al. 2022

CMAJ

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Background: When patients and physicians speak the same language, it may improve the quality and safety of care delivered. We sought to determine whether patient-physician language concordance is associated with inhospital and postdischarge outcomes among home care recipients who were admitted to hospital. Methods:We conducted a populationbased study of a retrospective cohort of 189 690 home care recipients who were admitted to hospital in Ontario, Canada, between 2010 and 2018. We defined patient language (obtained from home care assessments) as English (Anglophone), French (Francophone) or other (allophone). We obtained physician language from the College of Physicians and Surgeons of Ontario. We defined

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Section: Discussionmentioning

confidence: 99%

Patient–physician language concordance and quality and safety outcomes among frail home care recipients admitted to hospital in Ontario, Canada

Seale

Reaume

Batista

et al. 2022

CMAJ

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“…ex., capacité d'obtenir une description des symptômes et des renseignements médicaux complets), ce qui peut aider les médecins à poser plus rapide ment un diagnostic précis 37,38 . Les médecins qui ne peuvent pas communiquer efficacement avec leurs patients sont plus susceptibles de demander des tests additionnels (parfois superflus) 39,40 , ce qui pourrait entraîner un risque accru d'événements indésirables et prolonger les hospitalisations. Une communication patientprofessionnel claire et efficace améliore aussi la coopération et la mobilisation des patients, ce qui est associé à de meilleurs résultats sur le plan de la santé 41 .…”

Section: Interprétationunclassified

Concordance linguistique patient–médecin et paramètres de qualité et de sécurité des soins chez les bénéficiaires de soins à domicile fragiles admis à l’hôpital en Ontario, au Canada

Seale

Reaume

Batista

et al. 2022

CMAJ

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De plus en plus de Canadiens et de Canadiennes (plus de 6,1 millions en 2016) sont exposés à la difficulté de vivre dans un milieu où une majorité des gens ne s'exprime pas dans leur langue maternelle, et où cette langue n'est pas reconnue comme une langue officielle par leur province ou leur territoire 1,2 . Ce sont les minorités linguistiques, qui incluent les francophones hors Québec, les anglophones vivant au Québec et toute la population résidant au Canada dont la langue maternelle est une autre langue que l'anglais ou le français (allophone). De nombreuses études ont montré qu'en Amérique du Nord, pour les personnes RechercheServices de santé Concordance linguistique patient-médecin et paramètres de qualité et de sécurité des soins chez les bénéficiaires de soins à domicile fragiles admis à l'hôpital en Ontario, au Canada

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“…This finding represents a health disparity where Asian and Hispanic patients are being significantly overtested for PE, with more unnecessary exposure to radiation. Notably, Asian and Hispanic patients might have been more likely to have limited English proficiency which is associated with lower CTPA yields when interpreters are not utilized (34). We did not have access to English language proficiency in our data set.…”

Section: Race and Ethnicitymentioning

confidence: 99%

Predictors of Overtesting in Pulmonary Embolism Diagnosis

et al. 2020

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Background: The benefits of computed tomography pulmonary angiography (CTPA) for pulmonary embolism (PE) diagnosis must be weighed against its risks, radiation-induced malignancy, and contrast-induced nephropathy. Appropriate use of CTPA can be assessed by monitoring yield, the percentage of tests positive for PE. We identify factors that are associated low CTPA yield, which may predict overtesting.Methods: This was a retrospective cohort study of six emergency departments between June 2014 and February 2017. The electronic health record was queried for CTPAs ordered for adult patients in the emergency department. We assessed the following patient factors: age, gender, body mass index, number of comorbidities, race, and ethnicity, provider factors: type (resident, fellow, attending, physician assistant) and environment factors: test time of day, season of visit, and crowdedness of the department.Results: A total of 14,782 CTPAs were reviewed, of which 1366 were found to be positive for PE, resulting in an overall CTPA yield of 9.24%. Provider type was not associated with a difference in yield. Testing was less likely to be positive in younger patients, females, those with lower body mass indexes and those identifying as Asian or Hispanic. Testing was also less likely to be positive when ordered during the overnight shift and during the winter and spring seasons. Conclusion:Our study identified several patient and environmental factors associated with low CTPA yield suggesting potential targets for overtesting. Targeting education and clinical decision support to assist providers in these circumstances may meaningfully improve yields.

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Implications of language barrier on the diagnostic yield of computed tomography in pulmonary embolism

Cited by 6 publications

References 9 publications

Patient–physician language concordance and quality and safety outcomes among frail home care recipients admitted to hospital in Ontario, Canada

Patient–physician language concordance and quality and safety outcomes among frail home care recipients admitted to hospital in Ontario, Canada

Concordance linguistique patient–médecin et paramètres de qualité et de sécurité des soins chez les bénéficiaires de soins à domicile fragiles admis à l’hôpital en Ontario, au Canada

Predictors of Overtesting in Pulmonary Embolism Diagnosis

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