{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:01:57Z","timestamp":1772118117555,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether presence of a psychiatric comorbidity impacts use of inpatient imaging tests and subsequent wait times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort study of all patients admitted to General Internal Medicine (GIM) at five academic hospitals in Toronto, Ontario from 2010 to 2019. Exposure was presence of a coded psychiatric comorbidity on admission. Primary outcome was time to test, as calculated from the time of test ordering to time of test completion, for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, or peripherally inserted central catheter (PICC) insertion. Multilevel mixed\u2010effects models were used to identify predictors of time to test, and marginal effects were used to calculate differences in absolute units (h). Secondary outcome was the rate of each type of test included. Subgroup analyses were performed according to type of psychiatric comorbidity: psychotic, mood\/anxiety, or substance use disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 196,819 GIM admissions from 2010to 2019.\u00a0In 77,562 admissions, \u22651 advanced imaging test was performed. After adjusting for all covariates, presence of any psychiatric comorbidity was associated with increased time to test for MRI (adjusted difference: 5.3\u00a0h, 95% confidence interval [CI]: 3.9\u20136.8), PICC (adjusted difference: 3.7\u00a0h, 95% CI: 1.6\u20135.8), and ultrasound (adjusted difference: 3.0\u00a0h, 95% CI: 2.3\u20133.8), but not for CT (adjusted difference: 0.1\u00a0h, 95% CI: \u22120.3 to 0.5). Presence of any psychiatric comorbidity was associated with lower rate of ordering for all test types (adjusted difference: \u221217.2 tests per 100\u00a0days hospitalization, interquartile range: \u221218.0 to \u221216.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There was a lower rate of ordering of advanced imaging among patients with psychiatric comorbidity. Once ordered, time to test completion was longer for MRI, ultrasound, and PICC. Further exploration, such as quantifying rates of cancelled tests and qualitative studies evaluating hospital, provider, and patient barriers to timely advanced imaging, will be helpful in elucidating causes for these disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.3425","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:38:10Z","timestamp":1708043890000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced imaging use and delays among inpatients with psychiatric comorbidity"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-6493","authenticated-orcid":false,"given":"Emily","family":"Bartsch","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeha","family":"Shin","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Toronto  Toronto Ontario Canada"},{"name":"Centre for Mental Health University Health Network  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Fralick","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine Sinai Health  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amol","family":"Verma","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine Unity Health Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahad","family":"Razak","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine Unity Health Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Lapointe\u2010Shaw","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine University Health Network  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Agency for Healthcare Research and Quality. 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