Evidence map›Paper›PMID 41025829›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2026

Clinically Significant Neuroimaging Findings Among Pediatric Patients Presenting to the Emergency Department With Symptoms of Psychosis: A Multicenter Retrospective Study.

Jennifer A Hoffmann, Tapan K Parikh, Doug Lorenz, Michael P Goldman, Emily M Powers, Shilpa J Patel, Ilana S Lavina, Theodore W Heyming, Jasmin T England, Mohsen Saidinejad and 32 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Jennifer A HoffmannDivision of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.ORCID 0000-0003-1653-363X
Tapan K ParikhPritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Doug LorenzDepartment of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA.
Michael P GoldmanYale University School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0003-1237-8820
Emily M PowersYale University School of Medicine, New Haven, Connecticut, USA.
Shilpa J PatelDivision of Emergency Medicine, Children's National Hospital, Washington, DC, USA.ORCID 0000-0002-9287-1430
Ilana S LavinaDivision of Emergency Medicine, Children's National Hospital, Washington, DC, USA.
Theodore W HeymingDepartment of Emergency Medicine, Children's Hospital of Orange County, Orange, California, USA.ORCID 0000-0003-0498-6375
Jasmin T EnglandDepartment of Emergency Medicine, Children's Hospital of Orange County, Orange, California, USA.
Mohsen SaidinejadThe Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Ilene ClaudiusHarbor-UCLA, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Pallavi GhoshChildren's Healthcare of Atlanta, Atlanta, GA, USA.
Daniel J ShapiroDivision of Pediatric Emergency Medicine, University of California, San Francisco, CA, USA.
Tricia B SwanAdventHealth Ocala, Ocala, Florida, USA.
Kamali L BouvayTriHealth Group Health Pediatrics and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Eileen Murtagh KurowskiCincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Nadine M SmithAdvocare Marlton Pediatrics, Marlton, NJ, USA.
Justin R DavisDepartment of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Alexander B MoxamDepartment of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Eli J MuhrerCharlie Health, Bozeman, MT, USA.ORCID 0000-0003-4693-3327
Rohit P ShenoiDivision of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Elyse N PortilloDivision of Pediatric Emergency Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Ron L KaplanDepartment of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA.
Neil G UspalSeattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA.ORCID 0000-0002-4280-0968
Robert M LapusMcGovern Medical School at UTHealth Houston, Houston, Texas, USA.
Andrea T VoTexas Children's Hospital, Houston, TX, USA.
Daniel B FensterDepartment of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Danielle B BarrocasColumbia University Irving Medical Center, New York, New York, USA.
Deborah R LiuChildren's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California, USA.
Pradip P ChaudhariChildren's Hospital Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, California, USA.
Rachel CaffertyDepartment of Pediatrics, Section of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.ORCID 0009-0000-6515-0892
Stephen B FreedmanDepartments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Jerri A RoseUniversity Hospitals-Rainbow Babies & Children's Hospital, Case Western Reserve School of Medicine, Cleveland, Ohio, USA.
Megan F EversUniversity Hospitals-Rainbow Babies & Children's Hospital, Case Western Reserve School of Medicine, Cleveland, Ohio, USA.
Ashley M MetcalfRady Children's Hospital San Diego, San Diego, California, USA.
Fareed SalehRady Children's Hospital San Diego, San Diego, California, USA.
Jennifer DunnickDepartment of Pediatrics, Division of Pediatric Emergency Medicine, Duke University Hospital, Durham, NC, USA.
Raymond D PitettiDepartment of Pediatrics, Division of Pediatric Emergency Medicine, Duke University Hospital, Durham, NC, USA.
Yashas R NathaniCook Children's Medical Center, Forth Worth, TX, USA.
Muhammad WaseemLincoln Medical Center, Bronx, New York, USA.
Todd A FlorinDivision of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Pediatric Emergency Medicine Collaborative Research Committee (PEMCRC) Psychosis Study Group

Funding

Caring Contacts via text message for suicidal adolescents after emergency department dischargeK23MH135206 · NIMH · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI Jennifer Ann Hoffmann · 2024 to 2026
$570k
Children's Research Fund Junior BoardNIMH NIH HHS K23 MH135206NIMH NIH HHS K23MH135206
6 · The paper itself

Abstract

backgroundThe clinical utility of diagnostic neuroimaging for pediatric patients presenting to the emergency department (ED) for psychosis remains unclear. We sought to estimate the prevalence of and characteristics associated with clinically significant neuroimaging findings among pediatric patients presenting to the ED with symptoms of psychosis who had neuroimaging performed.

methodsThis retrospective cross-sectional study included visits by patients 5 to < 18 years old presenting with symptoms of psychosis to 28 EDs affiliated with the Pediatric Emergency Medicine Collaborative Research Committee from 2016 to 2019 and had neuroimaging performed. We estimated the rate of clinically significant neuroimaging findings, defined as those resulting in further testing, treatment, or medical admission, overall and by imaging modality. Multivariable logistic regression models examined presenting features associated with clinically significant findings.

resultsClinically significant neuroimaging findings were identified in 5.4% (95% CI 4.2%, 6.9%) of 1118 ED visits (54% male, median [IQR] 14 [11-16] years old). Clinically significant findings occurred in 4.9% (34/699) of head computed tomography scans and 7.5% (45/604) of brain magnetic resonance imaging studies (p = 0.07). In a model that imputed missing data, no presenting features were associated with clinically significant neuroimaging findings. In a model that treated missing documentation as absence of the clinical feature, the adjusted odds of clinically significant neuroimaging findings were lower among ED visits by patients with suspected alcohol or substance use (aOR 0.38, 95% CI 0.16, 0.87).

conclusionAmong pediatric patients presenting to the ED with symptoms of psychosis who had neuroimaging obtained, approximately 1 in 20 had clinically significant findings. Suspected alcohol or substance use was associated with lower odds of clinically significant neuroimaging findings, although this finding was not consistent across modeling approaches. Prospective studies are needed to definitively evaluate the utility of neuroimaging among children and adolescents presenting to the ED with symptoms of psychosis.

Indexed as

Emergency Service, HospitalNeuroimagingPsychotic DisordersAdolescentChildChild, PreschoolCross-Sectional StudiesFemaleHumansMagnetic Resonance ImagingMaleRetrospective StudiesTomography, X-Ray Computed

Identifiers

PMID41025829
PMCPMC12517762

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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.