Date of Award

January 2016

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Edward R. Melnick


Our objective was to describe empathy in a cohort of emergency physicians and evaluate its association with CT utilization. We also sought to compare emergency physician performance on an empathy psychometric test with performance on other psychometric tests previously proposed as predictors of CT utilization. This cross-sectional study included two parts: (1) a secondary analysis of emergency department (ED) CT imaging utilization data at a large health system and (2) a survey study of the cohort of physicians responsible for this imaging using four psychometrics: the Jefferson Scale of Empathy (JSE), a risk-taking subset of the Jackson Personality Index (RTS), the stress from uncertainty scale (SUS), and the fear of malpractice scale (FMS). A hierarchical, mixed-effects regression model was used to evaluate the association between emergency physician performance on the four psychometric scales and risk-adjusted CT imaging utilization. The survey response rate was 74 of 82 (90.2%) eligible physicians. CT variation analysis included 113,517 patients seen during the study period by these 74 emergency physicians; 20,972 (18.5%) of these patients had at least one CT. There were no significant associations between performances on any of the psychometric scales and CT utilization. Performances on the JSE, RTS, SUS or FMS were not predictive of risk-adjusted CT utilization in the ED. The underlying physician-based factors that mediate inter-physician variation remain to be clearly identified.


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