Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 13, 2021
Date Accepted: May 18, 2022
Does the Use of Low-Slice Computed Tomography Machines in the Outpatient Setting Impact Downstream Care?: The Association between 16-slice versus 64-slice CT Angiography of the Neck and Subsequent Cervicocerebral Angiography
ABSTRACT
Background:
While computed tomography (CT) studies performed on machines with more slices have higher positive and negative predictive values, the impact of using low-slice (16-slice) CT machines on downstream testing has not been well-studied. In community outpatient settings, low-slice CT remains in use, although many hospitals have adopted higher-slice machines.
Objective:
This study examines the association between use of low-slice CT and downstream invasive testing in the context of CT angiography of the neck.
Methods:
Included claims pertained to adults with commercial or Medicare Advantage health plans who had CT angiography of the neck. Site certification data were used to assign counts of slices to claims. Claims in the 60 days post-CT were examined for cervicocerebral angiography. The association between slices and cervicocerebral angiography was evaluated using a Chi-square test and multivariate logistic regression.
Results:
Claims for 16-slice CT had a 5.1% (33/641) downstream cervicocerebral angiography rate, while claims for 64-slice CT had a 3.1% (35/1,125) rate, a significant difference (P=0.03). An analysis adjusted for patient demographics also found a significant relationship (OR: 1.64; 95% CI: 1.00-2.69).
Conclusions:
The use of low-slice CT machines in the community may impact quality of care and lead to more downstream testing. Clinical Trial: This is not a trial. This study was reviewed and approved by Advarra’s Institutional Review Board (Pro00033618). The Institutional Review Board granted a waiver of informed consent for the study due to its aggregate, retrospective, observational nature.
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