ArticleThe western journal of emergency medicine2017
Head CT for Minor Head Injury Presenting to the Emergency Department in the Era of Choosing Wisely.
Article in The western journal of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 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
- Cost of Low-Value Imaging Worldwide: A Systematic Review.Applied health economics and health policy · 2024Pooled it
- Interventions to reduce low-value imaging - a systematic review of interventions and outcomes.BMC health services research · 2021Pooled it
- Evaluation of a targeted, theory-informed implementation intervention designed to increase uptake of emergency management recommendations regarding adult patients with mild traumatic brain injury: results of the NET cluster randomised trial.Implementation science : IS · 2019Trial
- Article
- Validating the falls decision rule: optimizing head CT use in older adults with ground-level falls.CJEM · 2025Article
- Clinical decision rules in predicting computed tomography scan findings and need for neurosurgical intervention in mild traumatic brain injury: a prospective observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Observational
- Patients suffering traumatic brain injury: patient characteristics, prehospital triage, primary referral and mortality - A population-based follow-up study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Clinical Indicators for Primary Cranial CT Imaging after Mild Traumatic Brain Injury-A Retrospective Analysis.Journal of clinical medicine · 2023Article
- Comparing blood biomarkers to clinical decision rules to select patients suspected of traumatic brain injury for head computed tomography.The neuroradiology journal · 2023Article
- Applicability of machine learning technique in the screening of patients with mild traumatic brain injury.PloS one · 2023Observational
- Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review.BMC medical imaging · 2022Article
- Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild traumatic brain injury: a prospective observational multicenter cohort study - "the PreTBI I study".Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Observational
- Evaluation of Acute Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Plasma Levels in Traumatic Brain Injury Patients with and without Intracranial Lesions.Neurotrauma reports · 2021Article
- Article
- Low-Value Diagnostic Imaging Use in the Pediatric Emergency Department in the United States and Canada.JAMA pediatrics · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe Choosing Wisely campaign currently recommends avoiding computed tomography (CT) of the head in low-risk emergency department (ED) patients with minor head injury, based on validated decision rules. However, the degree of adherence to this guideline in clinical practice is unknown. The objective of this study was to evaluate adherence to the Choosing Wisely campaign's recommendations regarding head CT imaging of patients with minor head injury in the ED.
methodsWe conducted a retrospective cohort study of adult ED patients at a Level I trauma center. Patients aged ≥ 18 years who presented to the ED with minor head injury were identified via International Classification of Diseases, 9th Revision, Clinical Modification codes. Medical record abstraction was conducted to determine the presence of clinical symptoms of the NEXUS II criteria, medical resource use, and head CT findings. We used descriptive statistics to characterize the study sample, and proportions were used to quantify guidelines adherence.
resultsA total of 489 subjects met inclusion criteria. ED providers appropriately applied the Choosing Wisely criteria for 75.5% of patients, obtaining head CTs when indicated by the NEXUS II rule (41.5%), and not obtaining head CTs when the NEXUS II criteria were not met (34.0%). However, ED providers obtained non-indicated CTs in 23.1% of patients. Less than 2% of the sample did not receive a head CT when imaging was indicated by NEXUS II.
conclusionED providers in our sample had variable adherence to the Choosing Wisely head-CT recommendation, especially for patients who did not meet the NEXUS II criteria.
Indexed as
Identifiers
What OpenQuestion holds
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.