CT Use in Children Has Not Decreased Since Publication of the PECARN Rule

In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) used more than 42,000 pediatric emergency department (ED) visits to derive and validate a prediction rule for neuroimaging of mild head injury (NEJM JW Emerg Med Oct 2009 and Lancet 2009; 374:1160). Fewer than 0.1% of low-risk children had clinically important injury — suggesting that such patients could safely avoid neuroimaging. Since then, the rule has been extensively validated.

These authors used an administrative database of more than 30 million U.S. ED visits to determine whether computed tomography (CT) use decreased since publication of the PECARN rule. Of approximately 4.5 million pediatric ED visits made for minor head injury from 2008 to 2013, approximately 2…