Initial, preliminary results
Time to diagnosis using point-of-care CT and off-site conventional CT: a multi-center comparison survey
The aim of this study was to assess efficiency and impact on diagnosis of point-of-care CT using MiniCAT and traditional medical CT. Patients and doctors were surveyed between the prescription of a CT scan and final diagnosis. One set of questions recorded time spent at each step of the process. Another set of questions to doctors aimed at capturing if diagnosis was affected when imaging was obtained immediately after the initial visit (i.e. point-of-care CT).
The initial results were obtained from 4 MiniCAT users and 30 patients. Surveys for patients undergoing traditional CT scanning could not be collected for this initial period, possible because of a low patient return rate, as well as the long waiting period for CT appointments. In addition, after scanning is performed, results maybe discussed on the phone only. Preliminary results using MiniCAT are shown in Figure 1 and 2.
Minutes
Figure 1 represents time spent between prescription and scanning. Pre-authorization took on average 8 minutes, scanning took 4 minutes and final diagnosis took 8 minutes. Therefore, a total of 20 minutes was necessary from prescription to scanning.
Figure 1
Note that this is the total average time spent by patients. Doctors were able to perform other consultations during this time frame, and return to the patient once the scan images were ready.
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Figure 2
Figure 2 represent how diagnosis was affected by the presence of the CT scan results. 75% of the initial temporary diagnosis was modified once CT was read. Note that this high number demonstrates that the prescription was appropriate |
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and necessary. It also suggests that initial clinical diagnosis is not sufficient to the final accurate diagnosis. More importantly, it demonstrates that, in the absence of immediate scanning, the final diagnosis is postponed until data is available. |
It was found that, in 57% of cases, medication was prescribed or modified as a result of CT scanning. Interestingly, it meant that 18% of all patients were not prescribed a medication they would have otherwise be given in the absence of a CT scan. This represents 24% of all modified diagnosis.
These results were also supported by written comments collected from doctors. A few examples are: “patient medications changed because significant infection not present”; “avoid further antibiotics”; “scan clear, therefore symptoms due to allergies”; “change surgical procedure”; “sinus clear – shorten course of antibiotics – no topical steroids”; “yes, stopped antibiotics after noting improvement”. |
