"When the decision to obtain a CT scan in a child with minor head trauma is not clear, this study shows that involving the guardian with a visual aid helps them understand the tradeoffs, and leads to better engagement, education and trust in their physician," said Nathan Kuppermann, professor and chair of emergency medicine at UC Davis Medical Center and a senior investigator of the study.
"Shared decision-making likely has a role in many similar situations where the clinical decision is not clear," Kuppermann said.
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According to the U.S. Centers for Disease Control and Prevention, more than 450,000 children are evaluated in emergency departments in the U.S. for head trauma each year. While CT imaging is the standard test for diagnosing TBIs, less than 10 percent of CT scans of children with minor head trauma show evidence of brain injury, and only 0.2 percent require neurosurgical intervention.
Prediction tools and shared decision-making with parents are approaches that enable emergency medicine physicians to apply the latest scientific evidence and patients' values and preferences to reduce children's lifetime exposure to ionizing radiation, which has been linked to the development of multiple cancers.
Other authors on the paper include Anupam B. Kharbanda, Leah Tzimenatos at UC Davis, Jeffrey P. Louie, Daniel M. Cohen, Lise E. Nigrovic, Jessica J. Westphal, Nilay d. Shah, Jonathan Inselman, Michael J. Ferrara, Jeph Herrin and Victor M. Monton.
JAMA Network Open publishes the very best clinical research across all disciplines, making research findings more accessible to the worldwide community of investigators and clinicians.
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