MARC details
| 000 -LEADER |
|---|
| fixed length control field |
04238nam a22006737a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
|---|
| fixed length control field |
210218s20212021 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
|---|
| International Standard Serial Number |
0735-6757 |
| 024 ## - OTHER STANDARD IDENTIFIER |
|---|
| Standard number or code |
10.1016/j.ajem.2020.10.067 [doi] |
| 024 ## - OTHER STANDARD IDENTIFIER |
|---|
| Standard number or code |
S0735-6757(20)30967-0 [pii] |
| 040 ## - CATALOGING SOURCE |
|---|
| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
|---|
| PMID |
33243536 |
| 245 ## - TITLE STATEMENT |
|---|
| Title |
Multi-center implementation of automated age-adjusted D-dimer results reduces unnecessary PE imaging. |
| 251 ## - Source |
|---|
| Source |
American Journal of Emergency Medicine. 40:181-183, 2021 02. |
| 252 ## - Abbreviated Source |
|---|
| Abbreviated source |
Am J Emerg Med. 40:181-183, 2021 02. |
| 252 ## - Abbreviated Source |
|---|
| Former abbreviated source |
Am J Emerg Med. 40:181-183, 2021 02. |
| 253 ## - Journal Name |
|---|
| Journal name |
The American journal of emergency medicine |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
|---|
| Year |
2021 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
|---|
| Manufacturer |
FY2021 |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
|---|
| Publication status |
ppublish |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
|---|
| Publication status |
ppublish |
| 266 ## - Date added to catalog |
|---|
| Date added to catalog |
2021-02-18 |
| 268 ## - Previous citation |
|---|
| -- |
American Journal of Emergency Medicine. 40:181-183, 2021 02. |
| 501 ## - WITH NOTE |
|---|
| Local holdings |
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
BACKGROUND: Several previous studies have investigated the clinical utility of age-adjusted D-dimer cutoffs for diagnosing pulmonary embolism (PE). |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
CONCLUSION: Implementation of an automated age-adjusted D-dimer positive reference value reduced CT and V/Q imaging in this population by 4.4% while increasing test accuracy in a regional, heterogeneous six-hospital system. Copyright (c) 2020. Published by Elsevier Inc. |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
METHODS: Retrospective study of all patients who had a D-dimer performed during ED visits between September 2015 to September 2018. On March 21, 2017, the D-dimer upper limit of normal system-wide was increased for patients over 50 to: Age (years) x 0.01mug/mL. D-dimer results were displayed as normal or high based on automated age adjustment. EHR Chart review was performed 1.5 years prior to implementation of age-adjusted D-dimer cutoffs, as well as 1.5 years after to evaluate mortality and test accuracy characteristics such as false negative rates. Comparisons were made using chi-square testing. |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
OBJECTIVES: We performed a pre/post implementation study, using data from a mid-Atlantic healthcare system comprising 6 hospitals and 400,000 ED visits to determine whether implementing age adjusted D-dimer cutoffs reduced the number of imaging tests performed. |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
RESULTS: 22,302 D-dimers were performed pre-implementation of which 10,837 (48.6%) were positive resulting in 7218 (32.3%) imaging studies. After implementation of age-adjusted d-dimer, 25,082 were performed of which 10,851 (43.2%) were positive resulting in 7017 (28.0%) imaging studies. (pre: 48.6%, post: 43.2%; p < 0.01). A significantly lower proportion of patients had a positive d-dimer (pre: 48.6%, post: 43.2%; p < 0.01) and underwent imaging post-implementation (pre: 32.3%, post: 28.0%; p < 0.05) a relative risk reduction of 13.3. This absolute risk reduction of 4.4% is associated with 1104 less scans in the post-implementation group while still increasing test accuracy from 53.7% to 59.2% (p < 0.05). |
| 546 ## - LANGUAGE NOTE |
|---|
| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
*Fibrin Fibrinogen Degradation Products/an [Analysis] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
*Pulmonary Embolism/bl [Blood] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
*Pulmonary Embolism/dg [Diagnostic Imaging] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Age Factors |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Aged |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Electronic Health Records |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Female |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Humans |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Male |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Middle Aged |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Reference Values |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Retrospective Studies |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Unnecessary Procedures |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
|---|
| Institution |
MedStar Institute for Innovation |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
|---|
| Institution |
MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION |
|---|
| Department |
Emergency Medicine |
| 656 ## - INDEX TERM--OCCUPATION |
|---|
| Department |
Medical Director |
| 657 ## - INDEX TERM--FUNCTION |
|---|
| Medline publication type |
Journal Article |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Davis, Jonathan |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Dubin, Jeffrey S |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Gillam, Michael |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Goyal, Munish |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Izzo, Joseph |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Maloy, Kevin |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Ratay, Mary Kathleen |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Wilson, Matthew |
| 790 ## - Authors |
|---|
| All authors |
Davis J, Davis-Allen P, Dubin J, Gillam M, Goyal M, Izzo J, Maloy K, Ratay MK, Wilson M |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
|---|
| DOI |
<a href="https://dx.doi.org/10.1016/j.ajem.2020.10.067">https://dx.doi.org/10.1016/j.ajem.2020.10.067</a> |
| Public note |
https://dx.doi.org/10.1016/j.ajem.2020.10.067 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
|---|
| Koha item type |
Journal Article |
| Item type description |
Article |
