News | Clinical Decision Support | July 18, 2018

CT Decision Instrument Reliably Guides Pediatric Blunt Trauma imaging Decisions

May decrease use of head CT imaging in low-risk pediatric populations

CT Decision Instrument Reliably Guides Pediatric Blunt Trauma imaging Decisions

This is a four-site prospective observational cohort. Image courtesy of Kirsty Challen, B.Sc., MBCHB, MRES, Ph.D., Lancashire Teaching Hospitals, United Kingdom.

July 18, 2018 — A new study finds The Pediatric NEXUS Head Computed Tomography (CT) Decision Instrument (DI) reliably identifies blunt trauma patients who require head CT imaging, and could significantly reduce the use of CT imaging. The findings of the study are published in the July issue of Academic Emergency Medicine, a journal of the Society for Academic Emergency Medicine (SAEM).

The lead author is Malkeet Gupta, M.D., MS, assistant clinical professor in the Department of Emergency Medicine at the University of California Los Angeles (UCLA).

The study by Gupta et al, validates the NEXUS Head Computed Tomography Decision Instrument in pediatric patients and provides clinicians with a highly sensitive tool to guide selective imaging decisions in blunt head injury patients. Unlike other decision instruments, the decision instrument asks providers to use clinical judgment to identify low-risk patients who need no imaging and then to apply the decision instrument to further reduce the planned imaging. This "judgment first, decision instrument second" approach may decrease head CT utilization in low-risk pediatric populations by up to 34 percent.

The findings of the study are discussed with Gupta in the featured episode of SGEM Hop (Skeptics Guide to EM Hot Off the Press).

Joshua S. Broder, M.D., director of the Emergency Medicine Residency Program and vice-chief for education in the Division of Emergency Medicine at Duke University School of Medicine, commented on the study, "This study provides another tool in our armamentarium for assessing pediatric patients with traumatic head injury and has the potential to reduce CT utilization. Some elements of the decision instrument are poorly predictive; scalp hematoma alone, for example, does not indicate substantial risk of injury. Changes in nomenclature could help. For example, the term 'high-risk' may not accurately describe patients who fail one or more measures on the instrument, as the rate of significant head injury in this group was approximately 7 percent. 'Non-low risk' or 'intermediate risk' may more accurately describe some patients who might be safely observed without imaging."

For more information: www.onlinelibrary.wiley.com

Reference

Gupta M., Mower W.R., Rodriguez R.M., Hendey G.W. "Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma." Academic Emergency Medicine, April 17, 2018. https://doi.org/10.1111/acem.13431

 

Related Content

Stereotactic Radiosurgery Effective for Pediatric Arteriovenous Malformation Patients
News | Radiation Therapy | April 19, 2019
Ching-Jen Chen, M.D., of the neurosurgery department at the University of Virginia (UVA) Health System, was the winner...
Video Plus Brochure Helps Patients Make Lung Cancer Scan Decision

Image courtesy of the American Thoracic Society

News | Lung Cancer | April 19, 2019
A short video describing the potential benefits and risks of low-dose computed tomography (CT) screening for lung...
FDA Clears GE's Deep Learning Image Reconstruction Engine
Technology | Computed Tomography (CT) | April 19, 2019
GE Healthcare has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) of its Deep Learning Image...
Surgically Guided Brachytherapy Improves Outcomes for Intracranial Neoplasms
News | Brachytherapy Systems | April 18, 2019
Peter Nakaji, M.D., FAANS, general practice neurosurgeon at Barrow Neurological Institute, presented new research on...
Check-Cap Initiates U.S. Pilot Study of C-Scan for Colorectal Cancer Screening
News | Colonoscopy Systems | April 15, 2019
Check-Cap Ltd. has initiated its U.S. pilot study of the C-Scan system for prevention of colorectal cancer through...
Gamma Knife radiosurgery has become the preferred radiation therapy option for patients with brain tumors at facilities like the Northwestern Medicine Cancer Center, pictured here

Gamma Knife radiosurgery has become the preferred radiation therapy option for patients with brain tumors at facilities like the Northwestern Medicine Cancer Center, pictured here. The technology is favored largely for its ability to precisely target tumors while sparing healthy tissue.

Feature | Radiation Oncology | April 11, 2019 | By Jeff Zagoudis
Brain tumors are some of the most complicated forms of cancer to treat due to their extremely sensitive location.
Deep Lens Closes Series A Financing for Digital AI Pathology Platform
News | Digital Pathology | April 09, 2019
Digital pathology company Deep Lens Inc. announced the closing of a $14 million Series A financing that will further...
Uterine Fibroid Embolization Safer and as Effective as Surgical Treatment
News | Interventional Radiology | April 05, 2019
Uterine fibroid embolization (UFE) effectively treats uterine fibroids with fewer post-procedure complications compared...
Videos | RSNA | April 03, 2019
ITN Editor Dave Fornell takes a tour of some of the most interesting new medical imaging technologies displa
News | Biopsy Systems | March 29, 2019
Dune Medical Devices has just completed the first in-man cases for Smart Biopsy, its percutaneous soft tissue biopsy...