Ben Lauing, Imaging Performance Partnership
A recent study from the Annals of Emergency Medicine seeks to prevent unnecessary CT scans and radiation exposure in pediatric patients who present with blunt torso trauma. The authors examined 12,044 children in 20 emergency departments and developed a seven step prediction rule that identifies children at low risk of needing immediate abdominal intervention.
Seven key factors to avert a pediatric CT
An upcoming article in the American Journal of Roentgenology provides another volley in the discussion around the appropriateness of using CT scans for emergency department patients complaining of abdominal pain.
The Debate Continues Over CT Use in the ED
Among the many studies that have uncovered a high prevalence of inappropriate imaging on a national level, yet another has made it to headlines. A retrospective study published in JAMA of emergency department visits using data from the National Hospital Ambulatory Medical Care Survey (1998-2007) revealed an increase in CT and MRI imaging of ED patients presenting with injury-related conditions. The purpose of the study was to determine whether increases in the percentage of CT and MRI scans ordered between 1998 and 2007 correlated with increases in the severity of presenting conditions. Surprisingly, despite a 9% increase (6% in 1998 to 15% in 2007) in the number of MRI or CT scans ordered for patients presenting with injury-related conditions, there was only a minor shift in the percentage of patients presenting with life-threatening conditions (0.3%). Additionally, researchers found no significant change in the percentage of patient admissions. The results indicate that despite no increases in the severity of presenting conditions, MRI or CT scanning increased three-fold between 1998 and 2007. Researchers also found that age, sex, insurance status, suggested patient wait time, and reported pain level all correlated with CT or MRI ordering behavior.
Injury-Related Conditions and ED Imaging Utilization