Table 2.
Ordering frequency of diagnostic tests during clinic visits
| Pre-Covid Visits | Covid-Era Visits | Odds Ratio (95% Confidence Interval) | ||||||
|---|---|---|---|---|---|---|---|---|
| All/In-Person | All | In-Person | Video | Telephone | Covid vs. Pre-Covid (Ref) | Video vs. In-Person* (Ref) | Telephone vs. In-Person* (Ref) | |
| N | 10591 | 11106 | 7775 | 1009 | 2322 | |||
| Diagnostic Tests | ||||||||
| Any Diagnostic Test | 7624 (72.0%) | 6009 (54.1%) | 5092 (65.5%) | 325 (32.2%) | 592 (25.5%) | 0.51 (0.48–0.54) | 0.20 (0.18–0.22) | 0.18 (0.17–0.19) |
| Electrocardiogram | 3092 (29.2%) | 1903 (17.1%) | 1873 (24.1%) | 4 (0.4%) | 26 (1.1%) | 0.51 (0.47–0.54) | 0.02 (0.01–0.03) | 0.05 (0.05–0.06) |
| Transthoracic Echocardiogram | 1650 (15.6%) | 1473 (13.3%) | 1262 (16.2%) | 75 (7.4%) | 136 (5.9%) | 0.93 (0.86–1.01) | 0.37 (0.32–0.43) | 0.36 (0.32–0.40) |
| Coronary CT Angiogram | 34 (0.3%) | 36 (0.3%) | 34 (0.4%) | 1 (0.1%) | 1 (0.0%) | 1.21 (0.75–1.95) | 0.34 (0.14–0.84) | 0.06 (0.02–0.25) |
| Nuclear Stress Imaging | 201 (1.9%) | 183 (1.6%) | 165 (2.1%) | 7 (0.7%) | 11 (0.5%) | 0.91 (0.74–1.12) | 0.24 (0.15–0.40) | 0.32 (0.24–0.43) |
| Stress Echocardiogram | 101 (1.0%) | 40 (0.4%) | 29 (0.4%) | 5 (0.5%) | 6 (0.3%) | 0.38 (0.26–0.55) | 0.73 (0.36–1.47) | 0.47 (0.25–0.86) |
| Exercise Stress Test | 16 (0.2%) | 5 (0.0%) | 4 (0.1%) | 1 (0.1%) | 0 (0.0%) | 0.14 (0.05–0.42) | 1.87 (0.36–9.69) | - |
| Coronary Artery Calcium Scan | 7 (0.1%) | 1 (0.0%) | 1 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0.11 (0.01–0.94) | - | - |
| Cardiac MRI | 57 (0.5%) | 43 (0.4%) | 35 (0.5%) | 2 (0.2%) | 6 (0.3%) | 0.92 (0.61–1.38) | 0.28 (0.11–0.73) | 0.67 (0.38–1.20) |
| External ECG Monitor | 234 (2.2%) | 195 (1.8%) | 162 (2.1%) | 14 (1.4%) | 19 (0.8%) | 0.85 (0.70–1.03) | 0.62 (0.45–0.85) | 0.47 (0.36–0.61) |
| Laboratory Tests | ||||||||
| Brain Natriuretic Peptide | 3558 (33.6%) | 2768 (24.9%) | 2473 (31.8%) | 79 (7.8%) | 216 (9.3%) | 0.69 (0.65–0.73) | 0.19 (0.16–0.22) | 0.24 (0.22–0.26) |
| Lipids | 1173 (11.1%) | 1124 (10.1%) | 985 (12.7%) | 38 (3.8%) | 101 (4.3%) | 0.94 (0.86–1.03) | 0.23 (0.19–0.29) | 0.34 (0.30–0.38) |
| Complete Blood Count | 2621 (24.7%) | 2153 (19.4%) | 1893 (24.3%) | 89 (8.8%) | 171 (7.4%) | 0.75 (0.70–0.80) | 0.33 (0.29–0.37) | 0.26 (0.24–0.28) |
| Metabolic Panel | 4867 (46.0%) | 3848 (34.6%) | 3311 (42.6%) | 178 (17.6%) | 359 (15.5%) | 0.68 (0.64–0.72) | 0.26 (0.23–0.29) | 0.27 (0.25–0.29) |
| Coagulation Tests | 880 (8.3%) | 562 (5.1%) | 493 (6.3%) | 41 (4.1%) | 28 (1.2%) | 0.64 (0.57–0.72) | 0.61 (0.50–0.74) | 0.22 (0.18–0.27) |
| ESR or CRP | 580 (5.5%) | 540 (4.9%) | 484 (6.2%) | 20 (2.0%) | 36 (1.6%) | 0.96 (0.84–1.08) | 0.30 (0.23–0.40) | 0.26 (0.21–0.31) |
*
In-Person refers to Covid-Era in-person visits
Odds ratios were adjusted by age, sex, race, insurance status, calendar date, visit length, and visit diagnoses (coronary artery disease, hypertension, atrial fibrillation/flutter, diabetes mellitus, valvular disease, and chronic kidney disease).
Odds ratios comparing remote vs. in-person visits during the Covid-Era were additionally adjusted by propensity weighting for remote visit