title: Advancing Patient-centered Outcomes in Emergency Diagnostic Imaging: A Research Agenda.
abstract: Diagnostic imaging is integral to the evaluation of many emergency department (ED) patients. However, relatively little effort has been devoted to patient-centered outcomes research (PCOR) in emergency diagnostic imaging. This article provides background on this topic and the conclusions of the 2015 Academic Emergency Medicine consensus conference PCOR work group regarding "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The goal was to determine a prioritized research agenda to establish which outcomes related to emergency diagnostic imaging are most important to patients, caregivers, and other key stakeholders and which methods will most optimally engage patients in the decision to undergo imaging. Case vignettes are used to emphasize these concepts as they relate to a patient's decision to seek care at an ED and the care received there. The authors discuss applicable research methods and approaches such as shared decision-making that could facilitate better integration of patient-centered outcomes and patient-reported outcomes into decisions regarding emergency diagnostic imaging. Finally, based on a modified Delphi process involving members of the PCOR work group, prioritized research questions are proposed to advance the science of patient-centered outcomes in ED diagnostic imaging.
authors.affiliation: Department of Emergency Medicine, University of California San Francisco & San Francisco General Hospital, San Francisco, CA.|Robert Wood Johnson Clinical Scholars Program and the U.S. Department of Veterans Affairs, Los Angeles, CA.|RAND Health, Santa Monica, CA.
authors.forename: Hemal K
authors.initials: HK
authors.lastname: Kanzaria
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.|Emergency Care Research Unit, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Aileen M
authors.initials: AM
authors.lastname: McCabe
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.|Center for Emergency Care Policy & Research, Perelman School of Medicine, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Meisel
authors.affiliation: Division of Health Care Policy and Research, Department of Health Sciences Research, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN.
authors.forename: Annie
authors.initials: A
authors.lastname: LeBlanc
authors.affiliation: Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Schaffer
authors.affiliation: Department of Emergency Medicine, Mayo Clinic, Rochester, MN.|Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
authors.forename: M Fernanda
authors.initials: MF
authors.lastname: Bellolio
authors.affiliation: Patient Representative, Falls Church, VA.
authors.forename: William
authors.initials: W
authors.lastname: Vaughan
authors.affiliation: Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.|Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Merck
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Applegate
authors.affiliation: Department of Emergency Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.|National Academic Center for Telehealth, Philadelphia, PA.
authors.forename: Judd E
authors.initials: JE
authors.lastname: Hollander
authors.affiliation: Department of Emergency Medicine, New York University, New York, NY.|Department Population Health, New York University, New York, NY.
authors.forename: Corita R
authors.initials: CR
authors.lastname: Grudzen
authors.affiliation: Emergency Care Research Unit, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Mills
authors.affiliation: Division of Emergency Medicine, Washington University School of Medicine, and the Washington University Emergency Care Research Core, St. Louis, MO.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Carpenter
authors.affiliation: Department of Emergency Medicine, Mayo Clinic, Rochester, MN.|Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.|Knowledge and Evaluation Research Unit, Division of Healthcare Policy Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Erik P
authors.initials: EP
authors.lastname: Hess
mesh_terms: D003245:Consensus Statements as Topic; D003657:Decision Making; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D063868:Patient Outcome Assessment; D018802:Patient-Centered Care