Reducing Trauma CT Without Missing Injuries

Switching from liberal to evidence-based use of computed tomography reduced costs and radiation without missing injuries.

Use of computed tomography (CT) during emergency department (ED) visits more than tripled from 1996 to 2007. Radiation from diagnostic imaging is thought to pose a significant risk of iatrogenic cancer, and its reduction is a target of quality improvements across the healthcare spectrum (JW Gen Med Jun 13 2012). Researchers used a Boston trauma center's registry to retrospectively compare CT use, CT charges, and missed diagnoses between 612 trauma patients admitted before and 611 patients admitted after implementation of evidence-based guidelines for use of diagnostic radiology in 15 trauma scenarios (e.g., blunt cerebrovascular injury, penetrating extremity injuries, electrical injuries).

Mean Injury Severity Scores were significantly lower…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education