IMAGE: Associate professor of pediatrics, emergency medicine and radiation, University of Pittsburgh, and medical director of point-of-care ultrasound at UPMC Children’s Hospital in Pittsburgh. view more
Credit: David Wallace
PITTSBURGH, January 29, 2021 – A study led by UPMC Children’s Hospital in Pittsburgh and the University of Pittsburgh School of Medicine shows black children are 18% less likely to get imaging tests as part of their emergency department trip compared to White children . Hispanic children are 13% less likely to have imitated the Whites.
The researchers suggest that this difference is due to overuse in White children, although misuse in minor children also seems to play a role. The root cause seems to come from all patient preferences and obvious bias among providers.
“There’s something else going on here that goes beyond the clinical level, that’s beyond the studies,” said study lead author Jennifer Marin, MD, M.Sc., associate professor to pediatrics, emergency medicine and radiation at Pitt, and point-ultrasound medical director of care at UPMC Children’s Hospital. “Cultural factors associated with race, gender, religion, etc., should not be associated with a test where it is clear that that test is not beneficial to the patient and may be harmful.”
The study, published today in Open JAMA Network, we used pediatric emergency department billing data from 52 hospitals across 27 states as well as the District of Columbia from 2016 to 2019 to measure racial differences across all types of diagnostic images. This is the largest, most comprehensive study of its kind to date.
Even after controlling for difficult reasons, such as health insurance, diagnosis and household income, the data showed that doctors ordered far fewer imaging tests for Black and Hispanic children than it did for White children. The impact was even stronger among patients who were not admitted to hospital – suggesting they were not seriously injured or ill.
Although the data cannot differentiate between a worthy test and a failed test, prior research has shown examples of more frequent pictures in White children compared to other races, with no difference in clinical outcomes. The researchers suspect that the differences they see in experiments are largely driven by unnecessary experiments among Whites.
That’s worrying because some images, especially CT scans and X-rays, show children being exposed to radiation, which tends to increase the risk of cancer.
“Non-essential CT at five years of age is not the same as non-essential CT at 70 years old,” Marin said. “If you think about it in terms of lifetime risk, a five-year-old child is five years old and developing malignancy, as opposed to a 70-year-old who is only 15 years old.”
Wrong items and waste in medical wear are also a concern when ordering unnecessary tests.
“We may get an image and the radiologist may see something – and it may not be clinically important – then the baby needs to be subjected to a test and examination downstream,” said Marin. that is an additional burden and pressure on the family and an additional cost to the health care system. “
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Additional authors of the study include Jonathan Rodean, MPP, and Matt Hall, Ph.D., of the Children’s Hospital Association; Elizabeth Alpern, MD, MSCE, of Ann & Robert H. Lurie Children ‘s Hospital in Chicago and Northwestern University Feinberg School of Medicine; Paul Aronson, MD, MHS, of Yale School of Medicine; Pradip Chaudhari, MD, of Los Angeles Children’s Hospital and USC Keck School of Medicine; Eyal Cohen, MD, M.Sc., of the Hospital for Sick Children; Stephen Freedman, MDCM, M.Sc., of Alberta Children’s Hospital; Rustin Morse, MD, MMM, of Nationwide Children’s Hospital; Alon Peltz, MD, MBA, from Harvard Medical School; Margaret Samuels-Kalow, MD, M.Phil., MSHP, of Massachusetts General Hospital; Samir Shah, MD, MSCE, of Cincinnati Children ‘s Hospital Medical Center; Harold Simon, MD, MBA, from Emory University School of Medicine; and Mark Neuman, MD, MPH, Boston Children ‘s Hospital and Harvard Medical School.
Contact further:
Andrea Kunicky
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Email: [email protected]
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About UPMC Children’s Hospital in Pittsburgh
Regionally, nationally, and globally, UPMC Children’s Hospital in Pittsburgh is a leader in the treatment of childhood conditions and diseases, a pioneer in the development of new and improved treatments, and a leading educator of the next generation of physicians. pediatrics and pediatric subspecies. With generous support from the community, UPMC Children ‘s Hospital has fulfilled this mission since its inception in 1890. UPMC Children is consistently recognized for its clinical, research, educational and advocacy achievements, including rankings in the top 10 on US News 2020-2021 & World Honor Roll Report of the best children’s hospitals in America. UPMC children are also ranked 15th among children’s hospitals and medical schools in funding for pediatric research provided by the National Institutes of Health (FY2019).
About the University of Pittsburgh School of Medicine
As one of the nation’s leading academic centers for biochemical study, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a wide range of disciplines in an ongoing effort to harness the power of new knowledge and improve the human condition . Managed primarily by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In a ranking recently released short with the National Science Foundation, Pitt was ranked fifth among all American federal universities. science and engineering research and development support.
Similarly, the School of Medicine is equally committed to enhancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and for training skilled clinicians. , compassionate and creative scientists with great potential to engage in world-class research. The School of Medicine is an academic partner of UPMC, which has partnered with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region’s economy. For more information about the School of Medicine, see http: // www.
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