title: Awareness and use of the Canadian computed tomography head rule for mild head injury patients among Chinese emergency physicians.
abstract: OBJECTIVE
  Computed tomography (CT) scan has been an increasingly essential diagnostic tool for emergency physicians (EPs) to triage emergency patients. Canadian computed tomography Head Rule (CCHR) had been established and widely used to spare patients with mild head injury from unnecessary radiation. However, the awareness of CCHR and its actual utilization among Chinese EPs were unknown. This survey was to investigate the awareness and use of CCHR and their associated characteristics among Chinese EPs.
  
  
  METHODS
  Questionnaire was randomly sent to EPs from different Chinese hospitals. Surveyed EPs were asked how well they know about the CCHR and how often they use the CCHR to guide head CT use. Association between the awareness and utilization of CCHR and the physicians' characteristics were analyzed using repeated-measures logistic regression.
  
  
  RESULTS
  About 41.7% of the total 247 responders noted they "very familiar" or "somewhat familiar" with CCHR while the utilization rate was 24.7%. With respect to the most important underlying barriers for the use of CCHR, approximate half (48.5%) cited "fear of malpractice" as the leading cause. "Received specific training regarding radiation dose of CT" was the significant predicting factor both for the awareness (OR 5.87; 95% CI, 3.08-11.21) and the use (OR 6.10, 95% CI, 2.91-12.80) of CCHR.
  
  
  CONCLUSIONS
  Fear of malpractice and lack of radiation risk knowledge were two main barriers to apply CCHR in the request of CT for patients with mild head injury. Furthermore, EPs with specific training about radiation risk of CT were more likely to know and use of CCHR.
authors.affiliation: Xin Huang, Department of Neurosurgery, 1st Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.affiliation: Jian-cang Zhou, Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Jian-Cang
authors.initials: JC
authors.lastname: Zhou
authors.affiliation: Kong-han Pan, Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Kong-Han
authors.initials: KH
authors.lastname: Pan
authors.affiliation: Hong-chen Zhao, Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
authors.forename: Hong-Chen
authors.initials: HC
authors.lastname: Zhao
keywords: Computed tomography; Emergency department; Guideline; Mild head injury