COMPUTED TOMOGRAPHY SCAN UTILIZATION PATTERNS IN PEDIATRIC PATIENTS WITH RE- CURRENT HEADACHE. DeVries A, Young R Wall E, et al. Pediatrics 2013;132:el.

摘要

Computed tomography (CT) is widely used in children with headache and normal history, though often unnecessarily. The authors of this study looked at "to what extent do current practice patterns for treatment of pediatric headache align with practice guidelines?"This retrospective, observational cohort analysis looked at CT usage across all practice settings and various specialties including emergency department (ED) utilization. The primary outcome was a binary of CT scano CT scan, and secondary outcomes evaluated multiple CT scans of the head and patients receiving a CT scan in conjunction with other head-related imaging. There were 15,836 children meeting criteria, with 26% (mean age, 11.8 years) having at least one CT scan and with 74% within 1 month of index diagnosis. In the logistic regression analysis, patients with ED visits were four times more likely to undergo a CT scan than those without an ED visit (p < 0.001) [95% CI 3.9-4.8]). Two-thirds of patients with CT scans were never seen in the E.