{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T10:23:22Z","timestamp":1793183002481,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aimed to evaluate the prevalence and impact of low\u2010value diagnostic tests at a regional, major\u2010referral, mixed Emergency Department (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010site, cross\u2010sectional study was conducted at Townsville University Hospital in April 2022. Adult patients (aged 18\u2009years and above) who underwent one of 10 specified diagnostic tests were included. The tests encompassed coagulation studies, urine cultures, blood cultures, cranial computed tomography (CT) in syncope, cranial CT in minor head injury, cervical spine CT in neck trauma, ankle X\u2010ray in acute ankle trauma, duplex lower extremity ultrasound in suspected deep vein thrombosis, CT pulmonary angiography in suspected pulmonary embolism, and CT kidney ureter bladder in renal colic. Tests were classified as low\u2010value based on Choosing Wisely recommendations, with their value determined by a research assistant using clinical documentation, prior to the availability of test results. Emergency clinicians were blinded to the study conduct.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of all diagnostic tests performed, 48.2% (276\/572) were deemed low\u2010value, including 50.6% of laboratory tests (246\/486) and 24.4% of imaging tests (21\/86). The median ED length of stay was 6.1\u2009h (IQR 3.9\u20138.5). Low\u2010value imaging tests contributed to 152 lost bed\u2010hours per 100 tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A substantial proportion of diagnostic tests were low\u2010value, exacerbating access block and reducing the availability of ED beds, thereby delaying timely emergency care. The implementation of evidence\u2010based, effective strategies is imperative to mitigate patient harm associated with low\u2010value diagnostic tests.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.70100","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T08:49:48Z","timestamp":1753087788000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Could Low\u2010Value Diagnostic Tests be Compounding Access Block? A Single\u2010Site, Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0070-2988","authenticated-orcid":false,"given":"Heidi","family":"Walker","sequence":"first","affiliation":[{"name":"Townsville University Hospital  Douglas Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6787-5915","authenticated-orcid":false,"given":"Courtney","family":"West","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Douglas Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Lawton","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Douglas Queensland Australia"},{"name":"James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3282-1861","authenticated-orcid":false,"given":"Theophilus I.","family":"Emeto","sequence":"additional","affiliation":[{"name":"James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Gangathimmaiah","sequence":"additional","affiliation":[{"name":"Townsville University Hospital  Douglas Queensland Australia"},{"name":"James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102018\u2010008338"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.7464"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.13978"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742\u20106723.12877"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)32585\u20105"},{"key":"e_1_2_8_7_1","unstructured":"\u201cChoosing Wisely. Our Mission \u201daccessed February 2 2022 https:\/\/www.choosingwisely.org\/our\u2010mission\/."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102020\u2010012576"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.01.029"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43678\u2010022\u201000349\u20102"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1062860620930329"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n117"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010021\u201006597\u20109"},{"key":"e_1_2_8_14_1","volume-title":"Access Block: Australasian College for Emergency Medicine","author":"ACEM","year":"2022"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742\u20106723.13738"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43678\u2010020\u201000065\u20109"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742\u20106723.13699"},{"key":"e_1_2_8_18_1","unstructured":"\u201cChoosing Wisely Champion Hospital: Victorian Agency for Health Information \u201d2023 https:\/\/www.bettersafercare.vic.gov.au\/improvement\/projects\/mtip\/choosing\u2010wisely\u2010champion\u2010hospital."},{"key":"e_1_2_8_19_1","unstructured":"\u201cWhat is Patient Flow?: NEJM Catalyst Innovations in Care Delivery \u201d2018 nejm.org."},{"key":"e_1_2_8_20_1","unstructured":"\u201cGood Practice Guide: Focus on Improving Patient Flow \u201d2017."},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2387"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.22.28926"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(07)61602\u2010x"},{"key":"e_1_2_8_24_1","unstructured":"Australasian College for Emergency Medicine \u201cPolicy on Standard Terminology Version 7 \u201d2023."},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2024.95"},{"key":"e_1_2_8_26_1","volume-title":"Overuse of Tests and Treatments in Canada\u2010Progress Report","author":"Information CIfH","year":"2022"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20210140"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742\u20106723.13814"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2020.12.027"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.10.026"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.15441\/ceem.17.233"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed\u20102020\u2010210345"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.1678"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01005\u201021"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm\u20102023\u2010112271"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102019\u2010010060"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70100","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T03:54:01Z","timestamp":1755834841000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,21]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/1742-6723.70100"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70100","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,21]]},"assertion":[{"value":"2024-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70100"}}