Trial reportBMJ (Clinical research ed.)2006
Immediate computed tomography or admission for observation after mild head injury: cost comparison in 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. Cited by 21 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 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
- Serum S100B Level in the Management of Pediatric Minor Head Trauma: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Medical outcome after immediate computed tomography or admission for observation in patients with mild head injury: 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
- The epidemiology of and management of pediatric patients with head trauma: a hospital-based study from Southern Sweden.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Predicting factors for abnormal brain computed tomography in children with minor head trauma.BMC emergency medicine · 2021Article
- Article
- Utility and effectiveness of the Scandinavian guidelines to exclude computerized tomography scanning in mild traumatic brain injury - a prospective cohort study.BMC emergency medicine · 2018Article
- The addition of S100B to guidelines for management of mild head injury is potentially cost saving.BMC neurology · 2016Article
- A Review of the Effectiveness of Neuroimaging Modalities for the Detection of Traumatic Brain Injury.Journal of neurotrauma · 2015Review
- [Mild head injury in children and adults: Diagnostic challenges in the emergency department].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2015Article
- [Mild head injury in children and adults. Diagnostic challenges in the emergency department].Der Unfallchirurg · 2015Article
- 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
- "Sport" and "non-sport" concussions.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2011Article
- The Irish 'health basket': a basket case?The European journal of health economics : HEPAC : health economics in prevention and care · 2010Article
- Outcome after complicated minor head injury.AJNR. American journal of neuroradiology · 2008Article
- Clinical management of patients with minor head injuries.International journal of health sciences · 2007Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the costs of immediate computed tomography during triage for admission with those of observation in hospital in patients with mild head injury.
designProspective cost effectiveness analysis within a multicentre, pragmatic 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 measuresDirect and indirect costs related to the mild head injury during the acute and three month follow-up period.
resultsOutcome after three months was similar for both strategies (non-significantly in favour of computed tomography). For the acute stage and complications, the cost was 461 euros (314 pounds sterling, 582 dollars) per patient in the computed tomography group and 677 euros (462 pounds sterling, 854 dollars) in the observation group; an average of 32% less in the computed tomography group (216 euros, 95% confidence interval -272 to -164; P < 0.001). Sensitivity analysis showed that computed tomography was the most cost effective strategy under a broad range of assumptions. After three months, total costs were 718 euros and 914 euros per patient-that is, 196 euros less in the computed tomography group (- 281 to - 114; P < 0.001). The lower cost of the computed tomography strategy at the acute stage thus remained unchanged during follow-up.
conclusionPatients with mild head injury attending an emergency department can be managed more cost effectively with computed tomography rather than admission for observation in hospital.
trial registrationISRCTN81464462.
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