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The following is a summary of “Interventions to Reduce Imaging in Children With Minor Traumatic Head Injury: A Systematic Review,” published in the November 2024 issue of Pediatrics by Lesyk et al.
Reducing unnecessary imaging for children with minor traumatic brain injuries (mTBI) in emergency departments (EDs) is vital for minimizing healthcare costs and radiation exposure.
Researchers conducted a retrospective study to assess the effectiveness of interventions aimed at reducing imaging in children with mTBI.
They searched 8 electronic databases and gray literature for comparative studies on interventions to reduce imaging in children with mTBI, 2 independent reviewers screened studies, assessed quality, and extracted data. The median relative risks with interquartile range (IQR) were reported. A multivariable metaregression identified predictors of relative change in imaging.
The results showed 28 studies, with 79% using before–after designs. The most common intervention was the Pediatric Emergency Care Applied Research Network (PECARN) rule (71%). Most (75%) used multifaceted interventions (median components: 3; IQR: 1.75 to 4). Before–after studies with multifaceted PECARN interventions reported decreased computed tomography (CT) head imaging (relative risk = 0.73; IQR: 0.60 to 0.89). Higher baseline imaging (P<.001) and additional intervention components (P=.008) were associated with larger reductions in imaging.
They concluded that implementing multifaceted interventions, including the PECARN decision rule, in EDs with high baseline CT ordering effectively reduced head imaging in children with mTBI.
