External Validation of Three Decision Rules for Pediatric Head Injury

Minor head trauma is a common reason for children to visit the emergency department (ED), but the vast majority of computed tomography (CT) scans are negative. Researchers prospectively compared and externally validated three clinical decision rules aimed at reducing avoidable CT: PECARN (Pediatric Emergency Care Applied Research Network), CATCH (Canadian Assessment of Tomography for Childhood Head Injury), and CHALICE (Children's Head Injury Algorithm for the Prediction of Important Clinical Events).

The study included 20,000 children and adolescents (age <18 years) who presented with head injury of any severity to 10 EDs in Australia and New Zealand over 3 years. Of these patients, 10% underwent head CT, 1% met the PECARN definition of cli…