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Kids' CT Scans Could be Reduced with Observation First

May 11, 2011 | Parker Waichman LLP

A new study says CT scans could be reduced in children with moderate head injuries if emergency room doctors opted for a period of observation before deciding on a scan. According to the study, which is published in the journal Pediatrics, such practices could result in 39 fewer CT scans for every 1,000 children evaluated for traumatic brain injury.

In conducting the study, researchers from Boston and UC Davis looked at outcomes from 40,000 pediatric head injury cases in 25 emergency departments from data gathered from PECARN (the Pediatric Emergency Care Applied Research Network.)   Of those cases, only 14 percent underwent an observation period before doctors decided whether or not to order a Tuscan.

There were differences between the groups. Thirty-one percent of those who underwent observation first were not subjected to a CT scan, compared to 35 percent who were not observed. The difference between the two groups widened when the head injuries were more severe. Children placed under observation first had half the likelihood of having to undergo a CT scan.

Doctors who went the observation route first were no less likely to miss an injury compared to those who went to a scan first.

Exposure to medical radiation can increase cancer risks, and children are especially vulnerable because their cells are still dividing rapidly.  Yet a 2007 study in the New England Journal of Medicine (NEJM) found that most doctors underestimate the radiation risk posed by CT scans. The same study authors believed there may be over 1 million unnecessary CT scans performed on American children annually.

A study recently published by the Cincinnati Children’s Hospital that reviewed trends across the U.S. revealed a massive five-fold increase in pediatric CT scan use in children that jumped from 330,000 (1995) to 1.65 million (2008).

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