TY  - JOUR
PY  - 2017//
TI  - How much risk are emergency department patients willing to accept to avoid diagnostic testing
JO  - Turkish journal of emergency medicine
A1  - Padalecki, Jeremy
A1  - Xu, K. Tom
A1  - Smith, Cynthia
A1  - Carrasco, Lynn
A1  - Hensley, Justin
A1  - Richman, Peter B.
SP  - 16
EP  - 21
VL  - 17
IS  - 1
N2  - OBJECTIVES: There is a paucity of research evaluating the risk tolerance of Emergency Department (ED) patients. We hypothesized that a significant percentage of ED patients surveyed would be comfortable with ≥5% risk of adverse outcome if they avoided testing in several hypothetical scenarios. <br><br>MATERIALS AND METHODS: This was a cross-sectional study of a convenience sample of stable inner-city ED patients. Patients completed a written survey and were asked four closed-answer questions regarding risk tolerance/willingness to refuse a test/procedure, including the following scenarios: #1: LP following CT head; #2 overnight serial troponins for rule out myocardial infarction; #3 CT for possible appendicitis, #4 parent deciding whether child should undergo head CT for low risk head injury. Risk preferences were stratified to ≥5% (high) and <5% (low). Multivariate logistic regressions performed for each scenario to control for confounding factors. <br><br>RESULTS: There were 217 patients in the study group; mean age 42 ± 15 years, 48% female, 66% Hispanic, 87% income < $40,000 income group. A substantial percentage of patients rated high risk tolerance for each scenario, including 31% for #1 (avoid LP), 25% for #2 (avoid cardiac rule-out admission), 27% for #3 (avoid CT for appendicitis), and 19% for #4 (avoid head CT for child). <br><br>DISCUSSION: For 3 of 4 scenarios, 25% or more of our patients would accept a high risk tolerance of adverse outcome to avoid further testing. <br><br>CONCLUSION: Our findings contribute further evidence to the growing body of literature supporting patient interest in shared decision making in the ED.<p />  <p>Language: en</p>
LA  - en
SN  - 1304-7361
UR  - http://dx.doi.org/10.1016/j.tjem.2016.09.009
ID  - ref1
ER  -