Device could help reduce number of head CT scans in EDs

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A handheld system that helps clinicians assess and triage patients with head injuries could prove effective in reducing the number of CT scans in emergency departments.

The device could reduce the number of standard CT scans for mild traumatic brain injury that occur each year, posits researchers who conducted a study on the device, developed by Bethesda, Md.-based BrainScope, which has developed a device cleared by the Food and Drug Administration to aid in the assessment of concussions and mild traumatic brain injuries.

The findings were released by researchers who wrote an article for the American Journal of Emergency Medicine.

The article, “Reduction in unnecessary CT scans head-injury in the emergency department using an FDA cleared device,” was based on a study conducted by physicians at Washington University Barnes Jewish Medical Center in St. Louis.

The study found that the device reduced the use of unnecessary head CT scans by nearly one third in a hospital emergency department setting, compared with standard clinical practice.

Emergency visits for mild traumatic brain injury have greatly increased because of increased awareness of potential consequences of such injuries, with about 5 million Americans seeking medical care for head injury in ERs each year. While more than 80 percent of patients with head injuries who go to the ER receive a head CT scan, more than 90 percent of them are found to be negative. This practice unnecessarily exposes these patients to radiation, increases the use of hospital ER resources and lengthens throughput times.

In the study, 91 patients came to the hospital’s ER with a head injury, and all were referred for a head CT scan. Patients also received a five- to 10-minute BrainScope EEG-based structural injury classifier evaluation using a proprietary disposable EEG headset, which is placed on the forehead region. The device uses proprietary artificial intelligence algorithms to determine whether a patient is likely CT positive or likely CT negative.

The device would have ruled out CT scans for 31 percent of the patients, whose results turned out to be negative.

"The use of such rapidly obtained, objective information has the potential to reassure ED physicians in making confident clinical decisions that their patients do not need a CT,” says the paper's lead author, Rosanne Naunheim, MD. “It will go a long way toward decreasing unnecessary radiation, decreasing the cost of care."

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