The effect of COVID-19 on emergency department imaging: what can we learn?

Sharperson, Camara; Hanna, Tarek N.; Herr, Keith D.; Zygmont, Matthew E.; Gérard, R; Johnson, Jamlik-Omari

doi:10.1007/s10140-020-01889-9

Cited by 12 publications

(14 citation statements)

References 17 publications

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“…Even though we did not investigate the patients' severity of illness, the relative increase of positive findings in the ED imaging examinations is consistent with the literature's findings, showing a more severe condition of patients being admitted to EDs [13,14]. In a recent study, Sharperson et al reviewed all ED visits at a 4-hospital academic health system; they found that the proportion of imaging study reports concluding "no disease" or "no acute disease" decreased from 56.7% to 40.6% [17].…”

Section: Discussionsupporting

confidence: 77%

“…In the same study, they found that sonography examinations were reduced by 40%; this trend is consistent with our findings [ 10 ]. A different study described a relative decrease of sonography examinations from 9.6% to 8.5% ( p < 0.001) [ 17 ]. Our results did not show a relative decrease in sonography examinations, as would be expected; however, there was a significant reduction of 73% in this type of examination, which requires close contact with the patient.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study, Sharperson et al . reviewed all ED visits at a 4-hospital academic health system; they found that the proportion of imaging study reports concluding “no disease” or “no acute disease” decreased from 56.7% to 40.6% [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Radiological findings encountered in the selected weeks in 2019 and 2020 organized in categories, modified from Vingiani et al[17] with the corresponding description of findings, was provided to all centres. If one of the reviewers came across a pathology/finding not listed, the new condition was added to the list with the description of the corresponding finding after a joint discussion with each of the centres' principal investigators.…”

mentioning

confidence: 99%

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The impact of COVID-19 on radiological findings in patients accessing the emergency department: a multicentric study

Vingiani¹,

Abadia²,

Belmonte³

et al. 2022

Pol J Radiol

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Purpose The aim of this multicentric study is to illustrate how the COVID-19 pandemic lockdown affected the workload and outcomes of radiological examinations in emergency radiology. Material and methods The exams performed in the radiology departments of 4 Italian hospitals during 3 weeks of the Italian lockdown were retrospectively reviewed and compared to the exams conducted during the same period in 2019. Only exams from the emergency department (ED) were included. Two radiologists from each hospital defined the cases as positive or negative findings, based on independent blind readings of the imaging studies. In the case of differences in the evaluation, consensus was reached amongst them via discussion. Continuous measurements are presented as median and interquartile range, while categorical measurements are presented as frequency and percentage; p -values were calculated using the t -test, Mann-Whitney test, and the c 2 test. Results There were 745 patients (53% male; 62 years [44-78]) who underwent radiological examinations in 2020 vs. 2623 (52% male; 56 years [35-76]) in 2019 ( p < 0.001). Furthermore, the total number of ED exams dropped from 3206 (2019) to 939 (2020), with a relative increase of CT examinations from 23% to 33% ( p < 0.001). The percentage of patients with a positive finding was significantly higher in 2020 (355, 48%) compared to 2019 (684, 26%) ( p < 0.001). Conclusions Our findings show that despite the reduction of emergency radiological examinations, there was a rela-tive increase in the number of positive cases. These significant findings are crucial to ensure better organization of radiology departments and improve patient management during similar health emergencies in the future.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The impact of COVID-19 on radiological findings in patients accessing the emergency department: a multicentric study

Vingiani¹,

Abadia²,

Belmonte³

et al. 2022

Pol J Radiol

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“…Sharperson et al 16 and Houshyar et al 17 reported an overall reduction of 12–35% in the total number of imaging requests placed by emergency departments in the USA during the pandemic compared to the pre-pandemic period. Similarly, Naidich et al 18 reported a 12.29% decline in imaging volume across various modalities.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Data Management on the Achievable Dose and Efficiency of Computed Tomography During the COVID-19 Era: A Facility-Based Ambispective Study

Al-Sharydah¹,

Hegazi²,

Al‐Othman³

et al. 2022

JMDH

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Purpose This study primarily aimed to evaluate the effectiveness of computational data management and analytical software for establishing departmental diagnostic reference levels (DRLs) for computed tomography (CT) scanning in clinical settings, and monitor achievable doses (ADs) for CT imaging, particularly during the coronavirus disease 2019 (COVID-19) era. Secondarily, it aimed to correlate these standards with national and international benchmarks. Patients and Methods This ambidirectional cohort study enrolled 4668 patients (6419 CT-based examinations) who visited King Fahd Hospital of the University from May 25, 2021, to November 4, 2021. Participants’ demographic data were acquired from their electronic medical charts, in addition to all corresponding CT-dose determinant parameters. The study was divided into two phases (pre- and post-data management) based on the implementation of digital data management software. Results In both phases of the study, the size-specific dose estimate (SSDE) was the most significant confounder of dose determination compared to the dose-length product (DLP) and computed tomography dose index (CTDI) (P = 0.003). The head was the most frequently imaged body region (pre-implementation, 1051 examinations [35.1%]; post-implementation, 1071 examinations [31.3%]; P = 0.001), followed by the abdominal region (pre-implementation, 616 examinations [20.6%]; post-implementation, 256 examinations [7.48%]; P = 0.001). Based on the SSDE, DLP, and volume CTDI, the average per-section radiation exposure among organ-based scanning type was highest for the lumbar spine during the pre- and post-implementation periods. Conclusion Data management software enabled the establishment of DRLs and reduction of ADs in CT examinations, which consequently improved key performance indicators, despite the ergonomic complexities of COVID-19. Institutions are encouraged to apply DRLs and ADs via automatic systems that monitor patient dose indices to evaluate aggregate results.

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