Trial reportBMJ (Clinical research ed.)2006
Medical outcome after immediate computed tomography or admission for observation in patients with mild head injury: randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01291706 (Prospective, Multicentre, Observational Study), which is not on this map. Cited by 26 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective, Multicentre, Observational Study
Who cites it
26 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Italian guidelines on the assessment and management of pediatric head injury in the emergency department.Italian journal of pediatrics · 2018Pooled it
- Scandinavian guidelines for initial management of minor and moderate head trauma in children.BMC medicine · 2016Guideline
- The risk of intra-cranial haemorrhage in those presenting late to the ED following a head injury: a systematic review.Systematic reviews · 2015Pooled it
- Interventions provided in the acute phase for mild traumatic brain injury: a systematic review.Systematic reviews · 2013Pooled it
- A systematic review of the reporting of Data Monitoring Committees' roles, interim analysis and early termination in pediatric clinical trials.BMC pediatrics · 2009Pooled it
- Academic achievement after a CT examination toward the head in childhood: Follow up of a randomized controlled trial.PloS one · 2023Trial
- Features of urine S100B and its ability to rule out intracranial hemorrhage in patients with head trauma: a prospective trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Trial
- Immediate computed tomography or admission for observation after mild head injury: cost comparison in randomised controlled trial.BMJ (Clinical research ed.) · 2006Trial
- Diagnostic accuracy of the Scandinavian guidelines for minor and moderate head trauma in children: a prospective, pragmatic, validation study.The Lancet regional health. Europe · 2025Article
- Pediatric head injury guideline use in Sweden: a cross-sectional survey on determinants for successful implementation of a clinical practice guideline.BMC health services research · 2024Article
- Observational
- Predicting factors for abnormal brain computed tomography in children with minor head trauma.BMC emergency medicine · 2021Article
- Article
- External validation of the Scandinavian guidelines for management of minimal, mild and moderate head injuries in children.BMC medicine · 2018Article
- Predictive factors of intracranial bleeding in head trauma patients receiving antiplatelet therapy admitted to an emergency department.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Article
- Biomarker-Guided Non-Adaptive Trial Designs in Phase II and Phase III: A Methodological Review.Journal of personalized medicine · 2017Review
- Utility of CT head in the acute setting: value of contrast and non-contrast studies.Irish journal of medical science · 2015Article
- Long-term neurological outcomes in adults with traumatic intracranial hemorrhage admitted to ICU versus floor.The western journal of emergency medicine · 2015Article
- Evaluation of the Scandinavian guidelines for head injuries based on a consecutive series with computed tomography from a Norwegian university hospital.Scandinavian journal of trauma, resuscitation and emergency medicine · 2012Article
- Identification of low-risk patients with traumatic brain injury and intracranial hemorrhage who do not need intensive care unit admission.The Journal of trauma · 2011Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare immediate computed tomography during triage for admission with observation in hospital in patients with mild head injury.
designMulticentre, pragmatic, non-inferiority randomised trial.
setting39 acute hospitals in Sweden.
participants2602 patients (aged > or = 6) with mild head injury.
interventionsImmediate computed tomography or admission for observation.
main outcome measureDichotomised extended Glasgow outcome scale (1-7 v 8). The non-inferiority margin was 5 percentage points.
resultsAt three months, 275 patients (21.4%) in the computed tomography group had not recovered completely compared with 300 (24.2%) admitted for observation. The difference was - 2.8 percentage points, non-significantly in favour of computed tomography (95% confidence interval - 6.1% to 0.6%). The worst outcomes (mortality and more severe loss of function) were similar between the groups. In the patients admitted for observation, there was a considerable delay in time to treatment in those who required surgery. None of the patients with normal findings on immediate computed tomography had complications later. Patients' satisfaction with the two strategies was similar.
conclusionsThe use of computed tomography in the management of patients with mild head injury is feasible and leads to similar clinical outcomes compared with observation in hospital.
trial registrationISRCTN81464462.
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