title: Variation in the self-reported use of computed tomography in clearing the cervical spine of pediatric trauma patients.
abstract: OBJECTIVE
  Cervical spine injury (CSI) in children can be life-threatening or associated with lifelong disabilities. Whereas screening computed tomography (CT) of the cervical spine is used in the evaluation of adult trauma patients, it has no additional benefit in children when compared with plain film radiography of the cervical spine. Despite this, CT use in the pediatric patient is increasing. We sought to compare the self-reported utilization of screening cervical spine CT among pediatric emergency medicine (PEM) physicians and general emergency medicine (non-PEM) physicians.
  
  
  METHODS
  Physicians completed an online survey consisting of a clinical vignette in which the respondents chose to evaluate a pediatric trauma patient for CSI using no imaging, plain films, or CT. Questions regarding the physician's attitudes, knowledge, and practice patterns for pediatric CSI were included.
  
  
  RESULTS
  Six hundred fifty-four physicians responded to the survey: 463 (70.8%) non-PEM and 191 (29.2%) PEM physicians. Both groups ordered radiographic imaging at a similar rate, although non-PEM physicians were 4 times more likely to utilize CT than PEM practitioners. Non-PEM physicians were more likely to overestimate the frequency of pediatric CSI. Pediatric emergency medicine physicians were more likely to state that they would never use CT as the initial modality for CSI screening.
  
  
  CONCLUSIONS
  In response to a clinical vignette, non-PEM physicians were more likely to self-report the use of screening CT in pediatric trauma patients than PEM physicians.
authors.affiliation: Section of Pediatric Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. lbrowne@mcw.edu
authors.forename: Lorin R
authors.initials: LR
authors.lastname: Browne
authors.forename: Nanette C
authors.initials: NC
authors.lastname: Dudley
authors.forename: Shannon
authors.initials: S
authors.lastname: Cox
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Adelgais
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D057566:Self Report / Q000706:statistics & numerical data*; D013124:Spinal Injuries / Q000000981:diagnostic imaging*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*