2024
Incidental Detection of Previously Unknown Strokes on Head CT Examinations: An Untapped Opportunity for Secondary Prevention
Kenny-Howell C, Dixe de Oliveira Santo I, Wira C, de Havenon A, Tu L. Incidental Detection of Previously Unknown Strokes on Head CT Examinations: An Untapped Opportunity for Secondary Prevention. Journal Of The American College Of Radiology 2024 PMID: 39571646, DOI: 10.1016/j.jacr.2024.11.010.Peer-Reviewed Original ResearchHead CT imagesEmergency departmentOld strokeSecondary preventionHead CTCT imagesRetrospective study of adult patientsImplement secondary preventionStudy of adult patientsAssociated with greater ageHead CT examinationsED careRisk of recurrent strokeED encountersUnivariate regressionCerebellar locationCT examinationsRetrospective studyAdult patientsIncidental detectionUnivariate analysisIncidental discoveryGreater ageMultivariate regressionPatientsAbbreviated MRI in the evaluation of dizziness: report turnaround times and impact on length of stay compared to CT, CTA, and conventional MRI
Tu L, Tegtmeyer K, de Oliveira Santo I, Venkatesh A, Forman H, Mahajan A, Melnick E. Abbreviated MRI in the evaluation of dizziness: report turnaround times and impact on length of stay compared to CT, CTA, and conventional MRI. Emergency Radiology 2024, 31: 705-711. PMID: 39034381, DOI: 10.1007/s10140-024-02273-7.Peer-Reviewed Original ResearchLength of stayEvaluation of dizzinessAbbreviated MRIConventional MRIMRI protocolEmergency departmentNon-contrast CT headConventional MRI protocolHead and neckPosterior circulation strokeAnalysis of length of stayTurnaround timeED length of stayCT headNo significant differenceAcute dizzinessCirculation strokeRetrospective analysisDizzinessAcute settingAssociated with greater impactMRI studiesImaging modalitiesMRIPatients
2023
Cost-Effectiveness of CT, CTA, MRI, and Specialized MRI for Evaluation of Patients Presenting to the Emergency Department With Dizziness.
Tu L, Melnick E, Venkatesh A, Sheth K, Navaratnam D, Yaesoubi R, Forman H, Mahajan A. Cost-Effectiveness of CT, CTA, MRI, and Specialized MRI for Evaluation of Patients Presenting to the Emergency Department With Dizziness. American Journal Of Roentgenology 2023, 222: e2330060. PMID: 37937837, DOI: 10.2214/ajr.23.30060.Peer-Reviewed Original ResearchQuality-adjusted life yearsEvaluation of patientsSecondary prevention measuresEmergency departmentProbabilistic sensitivity analysesConventional MRICumulative quality-adjusted life yearsCost-effective strategyIncremental costNoncontrast CT headAcute stroke treatmentSpecialized MRISelection of patientsHigher quality-adjusted life yearsConventional brain MRIMarkov decision-analytic modelNon-contrast CTNoncontrast head CTHealthcare system perspectiveUse of MRIBase-case analysisPrevention measuresDecision analytic modelGreater quality-adjusted life yearsDeterministic sensitivity analysesCT With CTA Versus MRI in Patients Presenting to the Emergency Department With Dizziness: Analysis Using Propensity Score Matching.
Tu L, Navaratnam D, Melnick E, Forman H, Venkatesh A, Malhotra A, Yaesoubi R, Sureshanand S, Sheth K, Mahajan A. CT With CTA Versus MRI in Patients Presenting to the Emergency Department With Dizziness: Analysis Using Propensity Score Matching. American Journal Of Roentgenology 2023, 221: 836-845. PMID: 37404082, DOI: 10.2214/ajr.23.29617.Peer-Reviewed Original ResearchConceptsSecondary stroke prevention medicationsStroke prevention medicationsEmergency departmentPrevention medicationsEchocardiography evaluationPosterior circulation strokeProportion of patientsGroup of patientsPhysical examination findingsNeuroimaging resultsUse of MRIReview of systemsGreater frequencyPropensity-score matchingExamination findingsRetrospective studyED readmissionMedical historyHead CTClinical impactMRI examinationsBrain MRINeck CTADizzinessPatientsClinical criteria to exclude acute vascular pathology on CT angiogram in patients with dizziness
Tu L, Malhotra A, Venkatesh A, Taylor R, Sheth K, Yaesoubi R, Forman H, Sureshanand S, Navaratnam D. Clinical criteria to exclude acute vascular pathology on CT angiogram in patients with dizziness. PLOS ONE 2023, 18: e0280752. PMID: 36893103, PMCID: PMC9997874, DOI: 10.1371/journal.pone.0280752.Peer-Reviewed Original ResearchConceptsAcute vascular pathologyEmergency departmentVascular pathologyNegative predictive valueDizzy patientsStroke codeCTA headPredictive valueAdult ED encountersTransient ischemic attackHalf of patientsLong-term smokersLarge vessel occlusionCoronary artery diseasePast medical historySeparate validation cohortCross-sectional analysisIschemic attackAnalysis cohortArterial dissectionArtery diseaseClinical factorsED encountersMedication useChief complaint
2021
Scenarios to improve CT head utilization in the emergency department delineated by critical results reporting
Tu LH, Venkatesh AK, Malhotra A, Taylor RA, Sheth KN, Forman HP, Yaesoubi R. Scenarios to improve CT head utilization in the emergency department delineated by critical results reporting. Emergency Radiology 2021, 29: 81-88. PMID: 34617133, DOI: 10.1007/s10140-021-01947-w.Peer-Reviewed Original ResearchConceptsAdult ED encountersCommon chief complaintChief complaintEmergency departmentED encountersPatient selectionHead examsLoss of consciousnessAcademic medical centerChest painBlood sugarRetrospective studyHead injuryMental statusNew headacheMedical CenterPsychiatric evaluationConclusionOur studyBetter outcomesAdvanced imagingAlcohol intoxicationTotal encountersComplaintsHeadacheSignificant differencesHead and Neck CTA Utilization: Analysis of Ordering Frequency and Nonroutine Results Communication, With Focus on the 50 Most Common Emergency Department Clinical Presentations.
Tu LH, Malhotra A, Venkatesh AK, Taylor RA, Sheth KN, Forman HP, Yaesoubi R. Head and Neck CTA Utilization: Analysis of Ordering Frequency and Nonroutine Results Communication, With Focus on the 50 Most Common Emergency Department Clinical Presentations. American Journal Of Roentgenology 2021, 218: 544-551. PMID: 34585611, DOI: 10.2214/ajr.21.26543.Peer-Reviewed Original ResearchConceptsNeck CTAED visitsEmergency departmentNonroutine communicationSingle health care systemAdult ED visitsSubset of reportsRadiologist communicationResult communicationPatient's chief concernHealth care systemFrequency of headCTA utilizationAcute findingsClinical presentationED settingPatient selectionIncidental findingClinical impactCTA examinationsCare systemCTAVisitsHigher numberNegative results