Urgent efforts needed globally to combat the spread of antimicrobial resistance, says WHO
Authors: J. Zarocostas
Journal: BMJ (2011)

<b>1077</b> <h3><b>Purpose:</b></h3> The purposes of this study are to 1. Identify patterns of use of PET/CT in inpatients in and outside of the United States (US) 2. Characterize the use of PET/CT in inpatients by location, institution type, percent of total PET/CT volume, and indications for which PET/CTs were performed. <b>Materials and Methods:</b> The study was reviewed by the IRB and deemed exempt. A link was sent to Society of Nuclear Medicine and Molecular Imaging (SNMMI) members via the SmartBrief weekly email, posted on the SNMMI website, and emailed to members of the SNMMI PET Centers of Excellence. Eligibility criteria were any physician who received e-mails from SNMMI or who accessed the SNMMI website. Study participants answered a 15 question online survey developed using REDCap. Data were collected from May to August 2018. Analyses were conducted using SAS Software 9.4 with the NPAR1WAY procedure. Differences were evaluated using the Kruskal-Wallis test. <h3><b>Results:</b></h3> 124 people responded to the survey, 71.8% (89/124) from the US, and 26.6% (33/124) from outside of the US (1.6% (2/124) no response to location question) (Figure 1). Percent of respondents by institution type is listed in Table 1. 81.5% (101/124) of respondents report reading PET/CTs on inpatients. The median percent of inpatient PET/CTs read by respondents was 8.0% (range 0-100). The median percent of inpatient PET/CTs read by respondents by institution type is listed in Table 2. The median percent inpatient PET/CTs read by respondents in the US was 5% (range 0-80%); outside of the USA was 17.7% (range 0-100%, p&lt;0.0001). By US region, the median percent inpatient PET/CTs read by respondents in the Northeast was 4.0% (range 0-50%), South 3.3% (range 0-50%), Midwest 12.9%, (range 0-80%), and West 5.0% (range 0-25%), p=0.0924. Indications for which respondents read inpatient PET/CTs are listed in Table 2 31.5% (39/124) of respondents did not know how hospitals are reimbursed in general (76.9% (30/39 from the US). 21.8% (27/124) of respondents did not know how hospitals are reimbursed for PET/CT (85.2% (23/27 from the US)). <h3><b>Conclusions:</b></h3> Most nuclear medicine physicians both in and outside of the US report read PET/CTs on inpatients, usually for the indication of cancer. Physicians outside of the US read a higher percent of inpatient PET/CTs than physicians in the US, but there was not a significant difference in percent of PET/CTs read by physicians among US regions. By institution type, physicians in government-affiliated institutions read the highest percent of PET/CTs and physicians in community non-teaching institutions read the least. Many respondents did not know how hospitals are reimbursed for admissions or for PET/CTs, which may affect the decision about whether and when to offer PET/CTs to inpatients. There are no publicized standards regarding the use of PET/CTs for inpatients. The results of this survey may help physicians performing and interpreting PET/CTs to evaluate whether their practice of providing PET/CTs to inpatients fits with current practice patterns demonstrated here. This survey represents a first step toward establishing a standard of care for providing inpatient PET/CTs.