Abstract
Purpose :
To evaluate the extent of unnecessary CT and MRI imaging for patients presenting to the ED with eye-related complaints at an academic, teritary-care medical center
Methods :
Retrospective review of electronic medical records of patients who presented to the ED with an eye-related complaint and received CT or MRI imaging between 2016-2018 at the Johns Hopkins Hospital. Necessity of imaging was defined as clinically necessary versus clinically unnecessary based the final diagnosis and a chart review by two independent physicians
Results :
We found approximately 33% (N=288/866) of all imaging performed in the ED setting for eye-related complaints to be clinically unnecessary. The most common complaints for which imaging was considered clinically unnecessary were related to visual disturbances, headaches, superficial eye injury, conjunctivitis, eye pain and glaucoma. The total cost estimate for this neuroimaging was $1.3 million for one year. Considering 30% of imaging was clinically unnecessary, reducing unnecessary imaging could potentially result in cost-savings of almost $400,000 each year for one healthcare system. Imaging resulted in a change in diagnosis 23% (N=196/866) of the times and a change in management 28% (N=241/866) of the times
Conclusions :
Almost one-thirds of all imaging currently performed in the ED setting for eye-related complaints is clinically unnecessary. Given the rising healthcare costs and that eye-related problems account for 2 million ED visits each year, it is important that advanced diagnostic imaging is performed only when clinically indicated and necessary to guide clinical management of patients. Routine use of imaging without clinical guidelines may result in excessive and unnecessary utilization of healthcare resources without any benefits to the patients
This is a 2020 ARVO Annual Meeting abstract.