ArticleThe American journal of emergency medicine2014
A conceptual model of emergency physician decision making for head computed tomography in mild head injury.
Article in The American journal of emergency medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis 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
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Overutilization of head computed tomography in cases of mild traumatic brain injury: a systematic review and meta-analysis.Emergency radiology · 2024Pooled it
- Influence of non-clinical factors on emergency department decision-making: a Delphi study.BMC emergency medicine · 2025Article
- Non-clinical factors influencing discharge and admission decisions in the emergency department: a focus group study among Israeli physicians.BMC emergency medicine · 2025Article
- Rate and yield of imaging for acute pyelonephritis in the emergency department: A retrospective cohort study.Emergency medicine Australasia : EMA · 2025Article
- Understanding the factors that influence CT utilization for mild traumatic brain injury in a low resource setting - a qualitative study using the Theoretical Domains Framework.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Chief complaints and computed tomography results in the emergency department: a three-year retrospective cohort study.BMC emergency medicine · 2024Article
- Physician choices in pulmonary embolism testing.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Article
- Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children: patient safety considerations.Pediatric radiology · 2018Review
- Tablet-Based Patient-Centered Decision Support for Minor Head Injury in the Emergency Department: Pilot Study.JMIR mHealth and uHealth · 2017Article
- Head CT for Minor Head Injury Presenting to the Emergency Department in the Era of Choosing Wisely.The western journal of emergency medicine · 2017Article
- Dissemination and Implementation of Shared Decision Making Into Clinical Practice: A Research Agenda.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2016Article
- Evaluation of hematological markers in minor head trauma in the emergency room.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2016Article
- The Association Between Physician Empathy and Variation in Imaging Use.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2016Article
- Prospective evaluation of the ability of clinical scoring systems and physician-determined likelihood of appendicitis to obviate the need for CT.Emergency medicine journal : EMJ · 2016Observational
- Back to the Bedside: Developing a Bedside Aid for Concussion and Brain Injury Decisions in the Emergency Department.EGEMS (Washington, DC) · 2015Article
- Whats New in Emergencies, Trauma and Shock? Computed Tomography Profile and its Utilization in Traumatic Brain Injury.Journal of emergencies, trauma, and shockArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
The use of computed tomographic scanning in blunt head trauma has increased dramatically in recent years without an accompanying rise in the prevalence of injury or hospital admission for serious conditions. Because computed tomography is neither harmless nor inexpensive, researchers have attempted to optimize utilization, largely through research that describes which clinical variables predict intracranial injury, and use this information to develop clinical decision instruments. Although such techniques may be useful when the benefits and harms of each strategy (neuroimaging vs observation) are quantifiable and amenable to comparison, the exact magnitude of these benefits and harms remains unknown in this clinical scenario. We believe that most clinical decision instrument development efforts are misguided insofar as they ignore critical, nonclinical factors influencing the decision to image. In this article, we propose a conceptual model to illustrate how clinical and nonclinical factors influence emergency physicians making this decision. We posit that elements unrelated to standard clinical factors, such as personality of the physician, fear of litigation and of missed diagnoses, patient expectations, and compensation method, may have equal or greater impact on actual decision making than traditional clinical factors. We believe that 3 particular factors deserve special consideration for further research: fear of error/malpractice, financial incentives, and patient engagement. Acknowledgement and study of these factors will be essential if we are to understand how emergency physicians truly make these decisions and how test-ordering behavior can be modified.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.