Identifying Unnecessary Irradiation of Patients with Suspected Renal Colic

识别疑似肾绞痛患者的不必要照射

基本信息

  • 批准号:
    8505332
  • 负责人:
  • 金额:
    $ 49.26万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2010
  • 资助国家:
    美国
  • 起止时间:
    2010-08-16 至 2014-07-31
  • 项目状态:
    已结题

项目摘要

6. Project Abstract: Identifying unnecessary irradiation of patients with suspected renal colic Up to 12% of the population has kidney stones, and 3-5% of all persons are likely to experience an episode of renal colic in their lifetime, many of whom will present to the Emergency Department (ED) for evaluation. Computed tomography (CT) scanning is now a first-line test for suspected renal colic, and is accurate in detecting stones. However CT scanning involves significant amounts of ionizing radiation, is costly, may lead to further unnecessary testing, and rarely alters management as most kidney stones pass spontaneously. CT scanning has increased dramatically in the U.S. over the last several decades, from approximately 3 million scans done in 1980 to over 60 million in 2007. In the year 2000 there were ~12 scans per 100 people, nearly doubling to ~22 per 100 people in 2005; during that time Medicare expenditures for imaging increased from $6.2 billion to $12 billion, accounting for 23% of all Medicare spending in 2005. Long term, the radiation received from a single CT scan of the abdomen/ pelvis has been estimated to cause approximately 12 deaths for every 10,000 scans performed. While other rules for imaging have been developed and implemented in the emergency setting, there is no decision rule to guide the use of appropriate imaging in suspected renal colic. We propose to derive, validate, and test the implementation of a decision rule that will allow appropriate use of CT scan in patients evaluated for suspected renal colic. The derivation set will consist of retrospectively derived data from all patients at our institution over a 4-year period who underwent a CT flank pain protocol (CT FPP) for suspected kidney stone. Classification and regression tree (CART) analysis will be utilized to derive a rule that will reliably predict the presence of kidney stone, as well as stones requiring intervention (6mm or greater), and other urgent or emergent diagnoses likely to require intervention. Once derived, this rule will be prospectively validated using point-of-care clinician performed ultrasound, plain films when appropriate, and data from the electronic medical record. In the final phase the rule will be implemented by physician training and incorporation into the computerized physician order entry (CPOE) system. The performance of the rule will be measured against CT findings and intervention during a 90-day follow-up period. Impact of the rule and cost benefit analysis will be evaluated to determine the comparative effectiveness of the derived rule. We anticipate a rule can be derived and validated, improving patient safety and reducing cost by reducing imaging that will not alter management in suspected renal colic.
6.项目摘要:确定疑似肾绞痛患者不必要的放射治疗 多达12%的人患有肾结石,所有人中有3%-5%的人可能经历过 他们中的许多人将被送往急诊科(ED)进行评估。 计算机断层扫描(CT)现在是疑似肾绞痛的一线检查,对 探测石头。然而,CT扫描涉及大量的电离辐射,成本高昂,可能会导致 进一步不必要的检查,很少改变治疗方法,因为大多数肾结石都是自发排出的。CT 在过去的几十年里,扫描技术在美国急剧增加,从大约300万台 从1980年的扫描增加到2007年的6000多万次。在2000年,每100个人有大约12次扫描,几乎 2005年翻了一番,达到每100人约22人;在此期间,用于成像的医疗保险支出从 62亿至120亿美元,占2005年医疗保险总支出的23%。从长远来看,辐射 从腹部/骨盆的一次CT扫描中感染的病毒估计已导致大约12人死亡 每执行10,000次扫描。 虽然已经开发并在紧急情况下实施了其他成像规则,但没有 用于指导疑似肾绞痛患者使用适当影像的决策规则。我们建议派生、验证 并测试决策规则的实施情况,该规则将允许在被评估的患者中适当使用CT扫描 疑似肾绞痛。派生集将包括来自我们的所有患者的回溯性派生数据 因疑似肾结石而接受CT腰部疼痛方案(CT FPP)治疗的患者超过4年。 将利用分类和回归树(CART)分析来导出将可靠地预测 存在肾结石,以及需要干预的结石(6毫米或更大),以及其他紧急或 紧急诊断可能需要干预。派生后,该规则将使用以下工具进行前瞻性验证 医疗保健中心的临床医生进行超声检查,适当时拍摄平片,并从电子医疗中获取数据 唱片。在最后阶段,该规则将通过医生培训和纳入 计算机化医嘱录入(CPOE)系统。该规则的性能将根据CT进行测量 在90天的随访期内的发现和干预。规则和成本效益分析的影响将是 评估以确定派生规则的相对有效性。我们预计可以推导出一条规则 并经过验证,通过减少不会改变管理的成像来提高患者安全性并降低成本 疑似肾绞痛。

项目成果

期刊论文数量(11)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Sonography first for acute flank pain?
急性腰痛首先要做超声检查吗?
Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone--the STONE score: retrospective and prospective observational cohort studies.
  • DOI:
    10.1136/bmj.g2191
  • 发表时间:
    2014-03-26
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Moore CL;Bomann S;Daniels B;Luty S;Molinaro A;Singh D;Gross CP
  • 通讯作者:
    Gross CP
The "Sinking" STONE.
“下沉”的石头。
  • DOI:
    10.1016/j.annemergmed.2016.03.021
  • 发表时间:
    2016
  • 期刊:
  • 影响因子:
    6.2
  • 作者:
    Moore,ChristopherL;Daniels,Brock;Luty,Seth;Gross,CaryP
  • 通讯作者:
    Gross,CaryP
Incidental findings on CT for suspected renal colic in emergency department patients: prevalence and types in 5,383 consecutive examinations.
急诊科患者疑似肾绞痛的 CT 偶然发现:5,383 次连续检查的患病率和类型。
Predictors of Hospital Admission and Urological Intervention in Adult Emergency Department Patients with Computerized Tomography Confirmed Ureteral Stones.
  • DOI:
    10.1016/j.juro.2017.06.077
  • 发表时间:
    2017-12
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Daniels B;Schoenfeld E;Taylor A;Weisenthal K;Singh D;Moore CL
  • 通讯作者:
    Moore CL
{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Christopher L Moore其他文献

White Paper: Best Practices in the Communication and Management of Actionable Incidental Findings in Emergency Department Imaging.
白皮书:急诊科影像中可操作的偶然发现的沟通和管理的最佳实践。
  • DOI:
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    4.5
  • 作者:
    Christopher L Moore;A. Baskin;A. Chang;D. Cheung;Melissa A. Davis;B. Fertel;Kristen Hans;Stella K. Kang;D. Larson;R. Lee;Kristin B McCabe;A. Mills;G. Nicola;L. Nicola
  • 通讯作者:
    L. Nicola

Christopher L Moore的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Christopher L Moore', 18)}}的其他基金

Minimizing Unnecessary Irradiation from Renal Colic CT Scans in the United States
在美国最大限度地减少肾绞痛 CT 扫描的不必要辐射
  • 批准号:
    8853119
  • 财政年份:
    2015
  • 资助金额:
    $ 49.26万
  • 项目类别:
Minimizing Unnecessary Irradiation from Renal Colic CT Scans in the United States
在美国最大限度地减少肾绞痛 CT 扫描的不必要辐射
  • 批准号:
    9042947
  • 财政年份:
    2015
  • 资助金额:
    $ 49.26万
  • 项目类别:
Identifying Unnecessary Irradiation of Patients with Suspected Renal Colic
识别疑似肾绞痛患者的不必要照射
  • 批准号:
    8311552
  • 财政年份:
    2010
  • 资助金额:
    $ 49.26万
  • 项目类别:
Identifying Unnecessary Irradiation of Patients with Suspected Renal Colic
识别疑似肾绞痛患者的不必要照射
  • 批准号:
    8128538
  • 财政年份:
    2010
  • 资助金额:
    $ 49.26万
  • 项目类别:
Identifying Unnecessary Irradiation of Patients with Suspected Renal Colic
识别疑似肾绞痛患者的不必要照射
  • 批准号:
    7984428
  • 财政年份:
    2010
  • 资助金额:
    $ 49.26万
  • 项目类别:

相似海外基金

Eradicating Unnecessary Single Use Plastic in Personal Care
消除个人护理中不必要的一次性塑料
  • 批准号:
    10055745
  • 财政年份:
    2023
  • 资助金额:
    $ 49.26万
  • 项目类别:
    Collaborative R&D
Using Machine Learning and Patient-Reported Outcomes to Identify Unnecessary Hospitalizations
使用机器学习和患者报告的结果来识别不必要的住院治疗
  • 批准号:
    10696203
  • 财政年份:
    2022
  • 资助金额:
    $ 49.26万
  • 项目类别:
Defining the Natural History and Drivers of Surgical Referral of Pediatric Umbilical Hernias to Reduce Unnecessary Surgery
定义小儿脐疝的自然史和手术转诊的驱动因素以减少不必要的手术
  • 批准号:
    10531478
  • 财政年份:
    2022
  • 资助金额:
    $ 49.26万
  • 项目类别:
Defining the Natural History and Drivers of Surgical Referral of Pediatric Umbilical Hernias to Reduce Unnecessary Surgery
定义小儿脐疝的自然史和手术转诊的驱动因素以减少不必要的手术
  • 批准号:
    10540235
  • 财政年份:
    2022
  • 资助金额:
    $ 49.26万
  • 项目类别:
Defining the Natural History and Drivers of Surgical Referral of Pediatric Umbilical Hernias to Reduce Unnecessary Surgery
定义小儿脐疝的自然史和手术转诊的驱动因素以减少不必要的手术
  • 批准号:
    10314578
  • 财政年份:
    2022
  • 资助金额:
    $ 49.26万
  • 项目类别:
Using Machine Learning and Patient-Reported Outcomes to Identify Unnecessary Hospitalizations
使用机器学习和患者报告的结果来识别不必要的住院治疗
  • 批准号:
    10509614
  • 财政年份:
    2022
  • 资助金额:
    $ 49.26万
  • 项目类别:
A study on unnecessary movements of athletes during games.
运动员在比赛中不必要动作的研究。
  • 批准号:
    21K11475
  • 财政年份:
    2021
  • 资助金额:
    $ 49.26万
  • 项目类别:
    Grant-in-Aid for Scientific Research (C)
Expanding and Scaling Two-way Texting to Reduce Unnecessary Follow-Up and Improve Adverse Event Identification Among Voluntary Medical Male Circumcision Clients in the Republic of South Africa
扩大和扩大双向短信,以减少南非共和国自愿医疗男性包皮环切术客户中不必要的后续行动并改善不良事件识别
  • 批准号:
    10191053
  • 财政年份:
    2020
  • 资助金额:
    $ 49.26万
  • 项目类别:
Clinical Communicator to reduce unnecessary hospital attendances
临床沟通器可减少不必要的就诊次数
  • 批准号:
    61884
  • 财政年份:
    2020
  • 资助金额:
    $ 49.26万
  • 项目类别:
    Feasibility Studies
Prevent Unnecessary Carotid Intervention and Stroke using Noninvasive Transcutaneous Ultrasound Thermal Strain Imaging (US-TSI)
使用无创经皮超声热应变成像 (US-TSI) 预防不必要的颈动脉干预和中风
  • 批准号:
    10192822
  • 财政年份:
    2020
  • 资助金额:
    $ 49.26万
  • 项目类别:
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了