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{ "pk": 18087, "title": "Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Abdominal pain is the leading emergency department (ED) chief complaint in older (≥65 years of age) adults, accounting for 1.4 million ED visits annually. Ultrasound and computed tomography (CT) are high-yield tests that offer rapid and accurate diagnosis for the most clinically significant causes of abdominal pain. In this study we used nationally representative data to examine racial/ethnic differences in cross-sectional imaging for older adults presenting to the ED with abdominal pain. </p>\n<p><strong>Methods:</strong> We performed a retrospective, cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to assess differences in the rate of imaging between White and Black older adults presenting to the ED for abdominal pain. Our primary outcome was the receipt of abdominal CT and/or ultrasound imaging. </p>\n<p><strong>Results:</strong> Across 1,656 older adult ED visits for abdominal pain, White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal CT and/or ultrasound than Black patients: 802 of 1,197 (67.0%) White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal computed tomography and/ or ultrasound than Black patients (P=0.01).</p>\n<p><strong>Conclusion:</strong> This study revealed that Black older adults presenting to the ED with abdominal pain receive significantly lower levels of cross-sectional imaging (CT/ultrasound) than White patients. Our findings highlight the need for further investigations into causes of disparities while initiating quality improvement processes to assess and address site- and clinician-specific patterns of care.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "abdominal pain" }, { "word": "CT" }, { "word": "ultrasound" }, { "word": "geriatric" }, { "word": "racial disparities" }, { "word": "imaging" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5r65r0cm", "frozenauthors": [ { "first_name": "Ijeoma", "middle_name": "", "last_name": "Unachukwu", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania; University of Pittsburgh Medical Center, Department of Psychiatry, Pittsburgh, Pennsylvania", "department": "" }, { "first_name": "Michael", "middle_name": "N.", "last_name": "Adjei-Poku", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Olivia", "middle_name": "C.", "last_name": "Sailors", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Rachel", "middle_name": "", "last_name": "Gonzales", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Eugenia", "middle_name": "", "last_name": "South", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania; University of Pennsylvania, Urban Health Lab, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Zach", "middle_name": "", "last_name": "Meisel", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Rachel", "middle_name": "R.", "last_name": "Kelz", "name_suffix": "", "institution": "University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania; University of Pennsylvania, Center for Surgery and Health Economics, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Anne", "middle_name": "R.", "last_name": "Cappola", "name_suffix": "", "institution": "University of Pennsylvania, Department of Endocrinology, Philadelphia, Pennsylvania; University of Pennsylvania School of Medicine, Institute of Aging, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Ari", "middle_name": "B.", "last_name": "Friedman", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania", "department": "" } ], "date_submitted": "2023-04-26T07:38:32-07:00", "date_accepted": "2024-11-27T19:15:43.939000-07:00", "date_published": "2025-02-28T10:50:00-07:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18087/galley/36382/download/" } ] }