title: Trends in computed tomography utilization in the pediatric emergency department.
abstract: OBJECTIVE
  The purpose of this study was to determine the overall trend of computed tomography (CT) utilization in the pediatric emergency department (PED) from 2003 to 2010 and to determine trends categorized by common chief complaints.
  
  
  METHODS
  Electronic chart records at 2 tertiary care PEDs within a large pediatric health care system were reviewed from January 2003 through December 2010. The annual CT utilization rate, by anatomic location, was determined. Annual CT utilization rates were compared with alternative imaging trends for visits with chief complaints of head injury, seizure, and abdominal pain. Analysis was performed with linear regression.
  
  
  RESULTS
  There was no change in overall CT utilization from 2003 to 2010 (β 0.25, 95% confidence interval [CI] [-1.61 to 2.73]) or within anatomic subgroups. Head CT utilization for the chief complaints of seizure (β -0.97, 95% CI [-1.44 to -0.90]) and head injury (β -0.93, 95% CI [-1.71 to -0.73]) showed significant declines. Although there was no change in the abdominal CT utilization rate for abdominal pain, abdominal ultrasound utilization for abdominal pain significantly increased (β 0.89, 95% CI [0.25-0.79]).
  
  
  CONCLUSIONS
  Our data showed no overall increase in CT utilization through 2010. In areas where alternative non-radiation-based modalities were options, there were decreased CT trends and increased use of potential alternative non-radiation-based modalities. This is the first large PED cohort study to show a decrease in CT utilization in recent years in a regional pediatric referral center and may correlate with increased awareness of radiation risk in children.
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA. mmenoch@emory.edu
authors.forename: Margaret J A
authors.initials: MJ
authors.lastname: Menoch
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hirsh
authors.forename: Naghma S
authors.initials: NS
authors.lastname: Khan
authors.forename: Harold K
authors.initials: HK
authors.lastname: Simon
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Sturm
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D010372:Pediatrics / Q000639:trends*; D011830:Radiation Effects; D011834:Radiation Monitoring; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*