Use of computed tomography scans on children being treated for headache remains too high considering the results often are not clinically useful while the children are exposed to unnecessary radiation, according to a new study in the journal Pediatrics.
“It’s ironic that providers sometimes use CT scans to rule out brain tumors or brain abnormalities because parents are concerned about this possibility--which is the cause of less than one percent of those with pediatric headache--when overuse of CT scans can increase the risk of brain tumors,” says Paul Young, M.D., a professor of pediatrics at the University of Utah School of Medicine and a study co-author.
The study was a retrospective analysis of 15,836 children aged three to 12 years old with more than two medical claims for headache. Using data from 2008, 1.7 million pediatric CT scans were performed in emergency departments, comprising nearly six percent of all pediatric ED visits that year. In all settings, 26 percent of the studied children had one or more CT scans within one month of diagnosis.
Pediatric patients with an ED visit for headache were four times more likely to get a scan versus those treated in other settings. “However, even outside the ED, use of CT scans remained widespread,” authors conclude. “Two-thirds of patients with CT scans had no ED use.”
Evaluation by a neurologist was strongly associated with lower use of CT scans, according to the study. The conclusion: “Use of CT scans to diagnose pediatric headache remains high despite existing guidelines, low diagnostic yield, and high potential risk. Implementing quality improvement initiatives to ensure that CT scans in children are performed only when truly indicated will reduce unnecessary exposure to ionizing radiation and associated cancer risks.”
The study in the July issue of Pediatrics, “CT Scan Utilization Patterns in Pediatric Patients with Recurrent Headache,” is available for purchase here.
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