Dr. Ralph Wang from University of California, San Francisco, who also recently reported a plateau in CT imaging of children with emergency visits for abdominal pain, told Reuters Health by email, “Several initiatives have been implemented to decrease inappropriate advanced imaging use, including payment reform (deficit reduction act), dissemination of research findings linking radiation from CT use to cancer, educational campaigns such as Imaging Gently/Choosing Wisely, clinical decision support in electronic health records, etc. Perhaps all of these efforts have resulted in a slowdown in imaging.”
“Despite the slowdown, inappropriate use of CT and other advanced imaging is likely to be considerable,” he said. “More evidence is needed to provide rational imaging guidelines for other clinical conditions, and these guidelines should be implemented.”
“Another piece of recently passed legislation – Protecting Access to Medicare Act (PAMA) – requires that clinicians who order advanced imaging first consult clinical decision support based on evidence-based imaging guidelines prior to ordering a study,” Dr. Wang added.
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One Response to “Too Many CT Scans for Pediatric Nontraumatic Abdominal Pain”
January 29, 2018
Robert AHow does ultrasound availability (9am-5pm weekdays vs 24/7) differ between sites that only have an adult ED vs adult/peds ED? I suspect that locations that have both (adult and peds ED) may have access to greater resources and more ultrasound availability. While perhaps adult EM providers share part of the blame for treating kids similarly to adults in regards to ordering CTs first, we should also be looking at centers with low rates of CT use in kids to see what they are doing well (greater availability of ultrasound, more experienced radiologists, surgeons who trust ultrasounds, etc).