{"id":"https://openalex.org/W2019130700","doi":"https://doi.org/10.1097/ccm.0b013e3182a63887","title":"Variation in Diagnostic Testing in ICUs","display_name":"Variation in Diagnostic Testing in ICUs","publication_year":2013,"publication_date":"2013-10-21","ids":{"openalex":"https://openalex.org/W2019130700","doi":"https://doi.org/10.1097/ccm.0b013e3182a63887","mag":"2019130700","pmid":"https://pubmed.ncbi.nlm.nih.gov/24145835"},"language":"en","primary_location":{"id":"doi:10.1097/ccm.0b013e3182a63887","doi":"https://doi.org/10.1097/ccm.0b013e3182a63887","is_oa":false,"landing_page_url":"https://doi.org/10.1097/ccm.0b013e3182a63887","pdf_url":null,"source":{"id":"https://openalex.org/S108732581","display_name":"Critical Care Medicine","issn_l":"0090-3493","issn":["0090-3493","1530-0293"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5035341487","display_name":"Jessica D. Spence","orcid":"https://orcid.org/0000-0003-1267-9455","observed_orcids":["https://orcid.org/0000-0003-1267-9455"]},"institutions":[{"id":"https://openalex.org/I46247651","display_name":"University of Manitoba","ror":"https://ror.org/02gfys938","country_code":"CA","type":"education","lineage":["https://openalex.org/I46247651"]},{"id":"https://openalex.org/I98251732","display_name":"McMaster University","ror":"https://ror.org/02fa3aq29","country_code":"CA","type":"education","lineage":["https://openalex.org/I98251732"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Jessica Spence","raw_affiliation_strings":["1Department of Anesthesia, McMaster University, Hamilton, ON, Canada. 2Department of Anesthesiology, University of Manitoba, Winnipeg, MB, Canada. 3Department of Medicine, University of Manitoba, Winnipeg, MB, Canada. 4Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada","Department of Anesthesia, McMaster University, Hamilton, ON, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"1Department of Anesthesia, McMaster University, Hamilton, ON, Canada. 2Department of Anesthesiology, University of Manitoba, Winnipeg, MB, Canada. 3Department of Medicine, University of Manitoba, Winnipeg, MB, Canada. 4Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada","institution_ids":["https://openalex.org/I46247651","https://openalex.org/I98251732"]},{"raw_affiliation_string":"Department of Anesthesia, McMaster University, Hamilton, ON, Canada","institution_ids":["https://openalex.org/I98251732"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103389366","display_name":"Dean D. Bell","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I46247651","display_name":"University of Manitoba","ror":"https://ror.org/02gfys938","country_code":"CA","type":"education","lineage":["https://openalex.org/I46247651"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Dean D. Bell","raw_affiliation_strings":["Department of Anesthesiology, University of Manitoba, Winnipeg, MB, Canada","Department of Medicine, University of Manitoba, Winnipeg, MB, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Anesthesiology, University of Manitoba, Winnipeg, MB, Canada","institution_ids":["https://openalex.org/I46247651"]},{"raw_affiliation_string":"Department of Medicine, University of Manitoba, Winnipeg, MB, Canada","institution_ids":["https://openalex.org/I46247651"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5028952390","display_name":"Allan Garland","orcid":"https://orcid.org/0000-0001-7129-936X","observed_orcids":["https://orcid.org/0000-0001-7129-936X"]},"institutions":[{"id":"https://openalex.org/I46247651","display_name":"University of Manitoba","ror":"https://ror.org/02gfys938","country_code":"CA","type":"education","lineage":["https://openalex.org/I46247651"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Allan Garland","raw_affiliation_strings":["Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada","Department of Medicine, University of Manitoba, Winnipeg, MB, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada","institution_ids":["https://openalex.org/I46247651"]},{"raw_affiliation_string":"Department of Medicine, University of Manitoba, Winnipeg, MB, Canada","institution_ids":["https://openalex.org/I46247651"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":1.8039,"has_fulltext":false,"cited_by_count":19,"citation_normalized_percentile":{"value":0.86644309,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":97},"biblio":{"volume":"42","issue":"1","first_page":"9","last_page":"16"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.948199987411499,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.948199987411499,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11314","display_name":"Clinical Laboratory Practices and Quality Control","score":0.013899999670684338,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12174","display_name":"Hospital Admissions and Outcomes","score":0.007199999876320362,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/diagnostic-testing","display_name":"diagnostic testing","score":0.7689999938011169},{"id":"https://openalex.org/keywords/intensive-care-unit","display_name":"intensive care unit","score":0.7639999985694885},{"id":"https://openalex.org/keywords/variation-in-care","display_name":"variation in care","score":0.5419999957084656},{"id":"https://openalex.org/keywords/laboratory-testing","display_name":"laboratory testing","score":0.7490000128746033},{"id":"https://openalex.org/keywords/electrocardiography","display_name":"electrocardiogram","score":0.9670000076293945},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.8379999995231628},{"id":"https://openalex.org/keywords/overuse-of-diagnostic-tests","display_name":"overuse of diagnostic tests","score":0.7630000114440918}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9423381090164185},{"id":"https://openalex.org/C119060515","wikidata":"https://www.wikidata.org/wiki/Q1916617","display_name":"Interquartile range","level":2,"score":0.8188791275024414},{"id":"https://openalex.org/C77350462","wikidata":"https://www.wikidata.org/wiki/Q1125472","display_name":"Confounding","level":2,"score":0.6580967903137207},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.6252215504646301},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.5850719809532166},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.535470187664032},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.48512017726898193},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.4703132212162018},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.46831661462783813},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.33856624364852905},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.17346975207328796},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000416","descriptor_name":"Alberta","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003955","descriptor_name":"Diagnostic Tests, Routine","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D004562","descriptor_name":"Electrocardiography","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006761","descriptor_name":"Hospitals","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006784","descriptor_name":"Hospitals, Teaching","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007362","descriptor_name":"Intensive Care Units","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D007902","descriptor_name":"Length of Stay","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010818","descriptor_name":"Practice Patterns, Physicians'","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D011859","descriptor_name":"Radiography","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019411","descriptor_name":"Clinical Laboratory Techniques","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1097/ccm.0b013e3182a63887","doi":"https://doi.org/10.1097/ccm.0b013e3182a63887","is_oa":false,"landing_page_url":"https://doi.org/10.1097/ccm.0b013e3182a63887","pdf_url":null,"source":{"id":"https://openalex.org/S108732581","display_name":"Critical Care Medicine","issn_l":"0090-3493","issn":["0090-3493","1530-0293"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care Medicine","raw_type":"journal-article"},{"id":"pmid:24145835","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/24145835","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical care medicine","raw_type":"Comparative Study"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.98580002784729,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":35,"referenced_works":["https://openalex.org/W1509759639","https://openalex.org/W1602862461","https://openalex.org/W1603121691","https://openalex.org/W1972282625","https://openalex.org/W1979444498","https://openalex.org/W1989985225","https://openalex.org/W1996870625","https://openalex.org/W2011695552","https://openalex.org/W2012543085","https://openalex.org/W2016598865","https://openalex.org/W2024717126","https://openalex.org/W2025129801","https://openalex.org/W2026032095","https://openalex.org/W2026972571","https://openalex.org/W2035190980","https://openalex.org/W2050050867","https://openalex.org/W2058099195","https://openalex.org/W2066105058","https://openalex.org/W2072174242","https://openalex.org/W2072492033","https://openalex.org/W2075264261","https://openalex.org/W2076820480","https://openalex.org/W2088875727","https://openalex.org/W2092527079","https://openalex.org/W2102140863","https://openalex.org/W2118711140","https://openalex.org/W2119457937","https://openalex.org/W2143430089","https://openalex.org/W2143618093","https://openalex.org/W2143715907","https://openalex.org/W2155796443","https://openalex.org/W2156934013","https://openalex.org/W2171697262","https://openalex.org/W2330786739","https://openalex.org/W2579233791"],"related_works":["https://openalex.org/W2012543085","https://openalex.org/W1973024821","https://openalex.org/W4311361894","https://openalex.org/W2041671089","https://openalex.org/W4246208763","https://openalex.org/W7162433821","https://openalex.org/W2943802322","https://openalex.org/W2000420657","https://openalex.org/W2321783686","https://openalex.org/W2061968755"],"abstract_inverted_index":{"OBJECTIVES:":[0],"To":[1],"explore":[2],"variation":[3],"in":[4,10,37,113,154,176,182,196,242,255,273,297],"the":[5,47,51,99,146,152,167,212,218,225],"use":[6],"of":[7,24,73,102,129,137,149,205,211,227,232],"diagnostic":[8,250,295],"testing":[9,269,284],"ICUs,":[11,62],"with":[12,125,291],"emphasis":[13],"on":[14],"differences":[15],"between":[16],"teaching":[17,32,61,177,197,215,243,299],"and":[18,33,79,110,135,140,179,230,276,300],"nonteaching":[19,35,183,256,301],"ICUs.":[20,198,257],"DESIGN:":[21],"Retrospective":[22],"review":[23],"a":[25],"prospective":[26],"clinical":[27],"ICU":[28,66,71,214],"database.":[29],"SETTING:":[30],"Five":[31],"four":[34],"ICUs":[36,49,178,244],"Winnipeg,":[38],"Canada,":[39],"during":[40,50],"2006-2010.":[41],"PATIENTS:":[42],"All":[43],"adults":[44],"admitted":[45],"to":[46,60,121,260,282,288],"nine":[48,103],"study":[52],"period":[53],"were":[54,85],"eligible.":[55],"After":[56,236],"excluding":[57],"subgroups":[58],"restricted":[59],"inter-ICU":[63],"transfers,":[64],"prior":[65,263],"admission":[67,132],"within":[68],"90":[69],"days,":[70],"length":[72,128,204],"stay":[74],"less":[75],"than":[76,224,253],"12":[77],"hours,":[78],"missing":[80],"death":[81],"dates,":[82],"10,262":[83],"patients":[84,241],"evaluated.":[86],"INTERVENTIONS:":[87],"None.":[88],"MEASUREMENTS":[89],"AND":[90],"MAIN":[91],"RESULTS:":[92],"Our":[93],"primary":[94],"outcome":[95],"variable":[96,202],"(TotalTesting)":[97],"was":[98,173,190,203,217],"cumulative":[100],"number":[101],"common":[104],"laboratory":[105],"tests,":[106,109,296],"three":[107],"radiologic":[108],"electrocardiograms":[111],"performed":[112],"each":[114],"ICU.":[115],"We":[116,144],"used":[117],"multivariable":[118,186],"median":[119,160,188],"regression":[120],"identify":[122],"factors":[123],"associated":[124],"TotalTesting,":[126],"including":[127],"stay,":[130,206],"demographics,":[131],"details,":[133],"type":[134],"severity":[136],"acute":[138],"illness,":[139],"specific":[141],"medical":[142,233],"interventions.":[143],"estimated":[145],"predictive":[147],"power":[148],"variables":[150,165],"as":[151],"decline":[153],"pseudo-R2":[155],"(a":[156],"goodness-of-fit":[157],"measure":[158],"for":[159,208,238,293],"regression)":[161],"when":[162],"omitting":[163],"those":[164,254],"from":[166],"model.":[168],"Median":[169],"(interquartile":[170],"range)":[171],"TotalTesting":[172,189],"27":[174],"(18-49)":[175],"20":[180],"(13-36)":[181],"units.":[184],"With":[185],"adjustment,":[187],"7.1":[191],"higher":[192],"(95%":[193],"CI,":[194],"6.6-7.7)":[195],"The":[199],"most":[200,220],"influential":[201],"accounting":[207],"almost":[209],"half":[210],"variation.":[213],"status":[216],"second":[219],"important":[221],"factor,":[222],"greater":[223],"degree":[226],"physiologic":[228],"derangement":[229],"details":[231],"management.":[234],"CONCLUSIONS:":[235],"adjustment":[237],"confounding":[239],"variables,":[240],"had":[245],"slightly":[246],"but":[247],"significantly":[248],"more":[249],"tests":[251],"done":[252],"In":[258],"addition":[259],"increasing":[261],"costs,":[262],"studies":[264],"have":[265],"shown":[266],"that":[267],"excessive":[268],"can":[270],"cause":[271],"harm":[272],"various":[274],"ways":[275],"does":[277],"not":[278],"improve":[279],"outcomes.":[280],"Interventions":[281],"reduce":[283],"should":[285],"be":[286],"directed":[287],"all":[289],"caregivers":[290],"responsibility":[292],"ordering":[294],"both":[298],"institutions.":[302]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2024,"cited_by_count":2},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":4},{"year":2021,"cited_by_count":1},{"year":2020,"cited_by_count":1},{"year":2019,"cited_by_count":1},{"year":2018,"cited_by_count":1},{"year":2017,"cited_by_count":2},{"year":2016,"cited_by_count":2},{"year":2013,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}
