Clinical Decision Support Reduces CT Use for Pediatric Head Injury

Significant brain injuries are rare in well-appearing children who undergo neuroimaging after head trauma. The Pediatric Emergency Care Applied Research Network (PECARN) derived and validated a rule to identify children at very low risk, but imaging use remains high, perhaps because the rule may prompt imaging for children with isolated, minor risk factors. These authors tested whether electronic decision support could decrease imaging for such children.

Providers at eight general and five pediatric emergency departments entered PECARN rule data for approximately 28,700 children. Of these children, 3859 were judged to have nonnegligible risk (0.2%–0.7%) of clinically important brain injury. For these children who presented during the interve…