In this investigation, the authors report the frequency of use of medical expulsive therapy (MET) in patients diagnosed with acute renal colic in emergency departments in the United States. This information is obtained from an annually updated government-sponsored database containing a systematic random sample of physician reported data on patient presenting complaints, diagnoses, and medications orders. The use of MET doubled yearly from 2000 through 2006; however, average use over the period was very low at 1.1% and peak use in 2006 was only 3.9%. Given the evidence that MET spares 1 in 4 patients from the need for surgical intervention, this low usage was unable to spve significant patient suffering and health system expense. Despite some limitations of the study that may overestimate the eligible population, the fact remains that a large number of patients who could have benefited from MET did not have it prescribed.
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