Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Emergency room CT exams have increased in children with abdominal pain

24.04.2012
Computed tomography (CT) utilization in pediatric patients with non-traumatic abdominal pain increased in emergency departments each year between 1999 and 2007, according to a new study published online in the journal Radiology.

The study authors found no corresponding increase in ultrasound use during the same period, despite research supporting it as an important diagnostic tool for assessing pediatric abdominal pain.

Non-traumatic abdominal pain is a common source of pediatric visits to the emergency department. Physicians often order CT exams when abdominal pain suggests appendicitis. While CT scans provide rapid, accurate diagnosis, they expose patients to ionizing radiation—an important consideration for children due to their longer life expectancy and increased susceptibility to radiation effects.

"Our findings help give us an overall understanding of places where we can tackle disparities of use and disparities in care," said Anastasia L. Hryhorczuk, M.D., clinical fellow at Children's Hospital Boston. "Ideally, we'd like to see the same standard of care being applied across the country to protect children from unnecessary radiation exposure."

Research has shown that step-by-step evaluations of pediatric patients, beginning with ultrasound and proceeding to CT if ultrasound is negative or uncertain, is the most accurate path for diagnosing appendicitis. Dr. Hryhorczuk and colleagues sought to determine if this strategy had been incorporated into general emergency department practices.

For the study, researchers looked at data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to evaluate imaging utilization among children with acute abdominal pain in U.S. emergency departments.

From 1999 to 2007, there were 16,900,000 pediatric emergency department visits for acute abdominal pain. The odds of a child receiving a CT scan increased during each year of the study period, despite the fact that there were no statistically significant changes in ultrasound usage, numbers of patients admitted to the hospital, or numbers of patients with acute appendicitis. Only three percent of patients ultimately diagnosed with appendicitis were imaged with both ultrasound and CT.

Children evaluated in pediatric emergency departments were more than 25 percent less likely than those seen at general emergency departments to undergo CT imaging for abdominal pain.

"In a pediatric setting, clinicians may have skills for evaluating patients that favor management without imaging, lowering CT usage," Dr. Hryhorczuk said.

Statistical analysis demonstrated increased odds of CT use in teens, white patients, the Midwest region, urban settings, patients with private insurance, and patients who were admitted or transferred.

Although the study did not investigate reasons for these variations, Dr. Hryhorczuk pointed out that CT scanners are readily available in hospitals, whereas access to ultrasound may be limited based on operator availability in some areas. The local legal climate also may play a factor in obtaining imaging exams, according to the study, as appendicitis diagnoses are a source of lawsuits in the pediatric emergency setting.

The time period of the study predates "Image Gently," a 2008 initiative of the Alliance for Radiation Safety in Pediatric Imaging that promotes radiation safety in the imaging of children. The researchers hope that further investigation of NHAMCS data will provide more information on the success of this and other programs aimed at lowering medical radiation exposure in children.

"Pediatric Abdominal Pain: Use of Imaging in the Emergency Department in the United States from 1999 to 2007." Collaborating with Dr. Hryhorczuk were Rebekah C. Mannix, M.D., M.P.H., and George A. Taylor, M.D.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)

RSNA is an association of more than 48,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on pediatric CT, visit RadiologyInfo.org.

Linda Brooks | EurekAlert!
Further information:
http://www.rsna.org

More articles from Medical Engineering:

nachricht High-resolution 3D view inside breast tumors with opto-acoustic mesoscopy
27.05.2020 | Technische Universität München

nachricht New double-contrast technique picks up small tumors on MRI
26.05.2020 | University of California - Davis

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Biotechnology: Triggered by light, a novel way to switch on an enzyme

In living cells, enzymes drive biochemical metabolic processes enabling reactions to take place efficiently. It is this very ability which allows them to be used as catalysts in biotechnology, for example to create chemical products such as pharmaceutics. Researchers now identified an enzyme that, when illuminated with blue light, becomes catalytically active and initiates a reaction that was previously unknown in enzymatics. The study was published in "Nature Communications".

Enzymes: they are the central drivers for biochemical metabolic processes in every living cell, enabling reactions to take place efficiently. It is this very...

Im Focus: New double-contrast technique picks up small tumors on MRI

Early detection of tumors is extremely important in treating cancer. A new technique developed by researchers at the University of California, Davis offers a significant advance in using magnetic resonance imaging to pick out even very small tumors from normal tissue. The work is published May 25 in the journal Nature Nanotechnology.

researchers at the University of California, Davis offers a significant advance in using magnetic resonance imaging to pick out even very small tumors from...

Im Focus: I-call - When microimplants communicate with each other / Innovation driver digitization - "Smart Health“

Microelectronics as a key technology enables numerous innovations in the field of intelligent medical technology. The Fraunhofer Institute for Biomedical Engineering IBMT coordinates the BMBF cooperative project "I-call" realizing the first electronic system for ultrasound-based, safe and interference-resistant data transmission between implants in the human body.

When microelectronic systems are used for medical applications, they have to meet high requirements in terms of biocompatibility, reliability, energy...

Im Focus: When predictions of theoretical chemists become reality

Thomas Heine, Professor of Theoretical Chemistry at TU Dresden, together with his team, first predicted a topological 2D polymer in 2019. Only one year later, an international team led by Italian researchers was able to synthesize these materials and experimentally prove their topological properties. For the renowned journal Nature Materials, this was the occasion to invite Thomas Heine to a News and Views article, which was published this week. Under the title "Making 2D Topological Polymers a reality" Prof. Heine describes how his theory became a reality.

Ultrathin materials are extremely interesting as building blocks for next generation nano electronic devices, as it is much easier to make circuits and other...

Im Focus: Rolling into the deep

Scientists took a leukocyte as the blueprint and developed a microrobot that has the size, shape and moving capabilities of a white blood cell. Simulating a blood vessel in a laboratory setting, they succeeded in magnetically navigating the ball-shaped microroller through this dynamic and dense environment. The drug-delivery vehicle withstood the simulated blood flow, pushing the developments in targeted drug delivery a step further: inside the body, there is no better access route to all tissues and organs than the circulatory system. A robot that could actually travel through this finely woven web would revolutionize the minimally-invasive treatment of illnesses.

A team of scientists from the Max Planck Institute for Intelligent Systems (MPI-IS) in Stuttgart invented a tiny microrobot that resembles a white blood cell...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Dresden Nexus Conference 2020: Same Time, Virtual Format, Registration Opened

19.05.2020 | Event News

Aachen Machine Tool Colloquium AWK'21 will take place on June 10 and 11, 2021

07.04.2020 | Event News

International Coral Reef Symposium in Bremen Postponed by a Year

06.04.2020 | Event News

 
Latest News

Black nitrogen: Bayreuth researchers discover new high-pressure material and solve a puzzle of the periodic table

29.05.2020 | Materials Sciences

Argonne researchers create active material out of microscopic spinning particles

29.05.2020 | Materials Sciences

Smart windows that self-illuminate on rainy days

29.05.2020 | Power and Electrical Engineering

VideoLinks
Science & Research
Overview of more VideoLinks >>>