{"doi":"10.1016/j.focus.2024.100270","title":"The COVID-19 Pandemic's Effect on Preventive Imaging","abstract":"Introduction We assessed the effect of the pandemic on preventive care imaging and potential disparities because preventive care may be perceived as non-urgent. The objective was to identify associations between the COVID-19 pandemic and changes in preventive imaging volumes for patients in general and as affected by race and ethnicities. Methods We performed a retrospective observational study by extracting the weekly volumes of all imaging studies between January 7, 2019 and May 1, 2022 from a radiology data warehouse at a tertiary care medical center (n = 92,105 preventive imaging studies and 3,493,063 total radiology imaging studies) and compared pre-shutdown and post-shutdown periods using a two sample t-test. Additional comparisons stratified by race and ethnicity were performed for mammograms and bone density exams using interrupted time series models with negative binomial error distribution to assess the immediate level change and trends over time of preventive imaging volumes post-shutdown. Results We found a significant decrease in bilateral mammograms, bone density exams, and aortic ultrasound exams in the post-shutdown period compared to the pre-shutdown period (p < 0.001, p = 0.003, and p = 0.001, respectively). There were no significant changes in low-dose CT chest exams (p = 0.46). The shutdown was associated with a significant immediate decrease in mammograms in the Hispanic and Latino group to approximately three-quarters of its pre-shutdown level (p = 0.04). For bone density exams, post-shutdown weekly volumes tripled compared to pre-shutdown volumes for Hispanic or Latino patients and doubled for non-Hispanic Black patients (p < 0.0001, for both). In comparison, a significant decrease was seen for \"Other\" patients (reduced to nearly a fifth of pre-shutdown volume, p < 0.0001). Conclusion There was a significant decrease in overall volume of bilateral mammograms, bone density exams, and aortic ultrasound exams post-pandemic shutdown. For mammograms, some of this decreasing trend was already seen pre-shutdown (such as for patients with \"Other\" race) so the shutdown was only specifically associated with an immediate decrease in mammogram levels in the Hispanic and Latino group. For bone density exams, the shutdown was unexpectedly associated with an increase in volumes for Hispanic or Latino patients and non-Hispanic Black patients, which was countered by a significant steep decrease in volumes only for patients of \"Other\" race. Health systems should carefully explore their preventive screening exam volumes to determine which patients should be actively engaged to assure catch up on recommended care.","journal":"AJPM Focus","year":2024,"id":502426,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8094,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":480786,"name":"Yin Xi","orcid":"0000-0001-9743-3010","position":1,"is_corresponding":false},{"id":1352067,"name":"Yee S. Ng","orcid":"0000-0002-3132-2075","position":2,"is_corresponding":false},{"id":1058353,"name":"Lauren N Cooper","orcid":"0000-0003-4000-9192","position":3,"is_corresponding":false},{"id":1135035,"name":"Marlon I. Diaz","orcid":"0000-0002-1870-2663","position":4,"is_corresponding":false},{"id":861691,"name":"Robert W. Turer","orcid":"0000-0003-1387-640X","position":5,"is_corresponding":false},{"id":932709,"name":"Samuel McDonald","orcid":"0000-0002-8383-3854","position":6,"is_corresponding":false},{"id":695439,"name":"DuWayne L. Willett","orcid":"0000-0002-3087-4193","position":7,"is_corresponding":false},{"id":703181,"name":"Christoph U. Lehmann","orcid":"0000-0001-9559-4646","position":8,"is_corresponding":false},{"id":1352068,"name":"Ling Chu","orcid":"0000-0002-4076-0923","position":9,"is_corresponding":false},{"id":973153,"name":"Jenny L. Weon","orcid":"0000-0002-4815-6659","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-19T02:10:23.709105Z","pmid":"39430624","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}