Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured children

Abstract Purpose: Research demonstrates that children receive twice as much medical radiation from Computed Tomography (CT) scans performed at non-pediatric facilities as equivalent CTs performed at pediatric trauma centers (PTCs). In 2014, AFMC outreach staff educated Emergency Department (ED) st...

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Main Authors: Rosemary Nabaweesi, Chary Akmyradov, Mary E. Aitken, Phillip J. Kenney, Raghu H. Ramakrishnaiah
Format: Article
Language:English
Published: Cambridge University Press 2021-01-01
Series:Journal of Clinical and Translational Science
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S2059866121007937/type/journal_article
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author Rosemary Nabaweesi
Chary Akmyradov
Mary E. Aitken
Phillip J. Kenney
Raghu H. Ramakrishnaiah
author_facet Rosemary Nabaweesi
Chary Akmyradov
Mary E. Aitken
Phillip J. Kenney
Raghu H. Ramakrishnaiah
author_sort Rosemary Nabaweesi
collection DOAJ
description Abstract Purpose: Research demonstrates that children receive twice as much medical radiation from Computed Tomography (CT) scans performed at non-pediatric facilities as equivalent CTs performed at pediatric trauma centers (PTCs). In 2014, AFMC outreach staff educated Emergency Department (ED) staff on appropriate CT imaging utilization to reduce unnecessary medical radiation exposure. We set out to determine the educational campaign’s impact on injured children received radiation dose. Methods: All injured children who underwent CT imaging and were transferred to a Level I PTC during 2010 to 2013 (pre-campaign) and 2015 (post-campaign) were reviewed. Patient demographics, mode of transportation, ED length of stay, scanned body region, injury severity score, and trauma center level were analyzed. Median effective radiation dose (ERD) controlled for each variable, pre-campaign and post-campaign, was compared using Wilcoxon rank sum test. Results: Three hundred eighty-five children under 17 years were transferred from 45 and 48 hospitals, pre- and post-campaign. Most (43%) transferring hospitals were urban or critical access hospitals (30%). Pre- and post-campaign patient demographics were similar. We analyzed 482 and 398 CT scans pre- and post-campaign. Overall, median ERD significantly decreased from 3.80 to 2.80. Abdominal CT scan ERD declined significantly from 7.2 to 4.13 (P-value 0.03). Head CT scan ERD declined from 3.27 to 2.45 (P-value < 0.0001). Conclusion: A statewide, CT scan educational campaign contributed to ERD decline (lower dose scans and fewer repeat scans) among transferred injured children seen at PTCs. State-level interventions are feasible and can be effective in changing radiology provider practices.
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spelling doaj.art-d9d0854600684d1da2461ebcff200d372023-03-09T12:31:02ZengCambridge University PressJournal of Clinical and Translational Science2059-86612021-01-01510.1017/cts.2021.793Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured childrenRosemary Nabaweesi0https://orcid.org/0000-0003-2467-4731Chary Akmyradov1https://orcid.org/0000-0002-2579-7146Mary E. Aitken2Phillip J. Kenney3Raghu H. Ramakrishnaiah4University of Arkansas for Medical Sciences, College of Medicine (COM), Pediatrics, Little Rock, AR, USA Arkansas Children’s Research Institute, Little Rock, AR, USAUniversity of Arkansas for Medical Sciences, COM, Biostatistics, Little Rock, AR, USAUniversity of Arkansas for Medical Sciences, College of Medicine (COM), Pediatrics, Little Rock, AR, USA Arkansas Children’s Research Institute, Little Rock, AR, USAUniversity of Arkansas for Medical Sciences, COM, Radiology, Little Rock, AR, USAUniversity of Arkansas for Medical Sciences, COM, Pediatric Radiology, Little Rock, AR, USA Abstract Purpose: Research demonstrates that children receive twice as much medical radiation from Computed Tomography (CT) scans performed at non-pediatric facilities as equivalent CTs performed at pediatric trauma centers (PTCs). In 2014, AFMC outreach staff educated Emergency Department (ED) staff on appropriate CT imaging utilization to reduce unnecessary medical radiation exposure. We set out to determine the educational campaign’s impact on injured children received radiation dose. Methods: All injured children who underwent CT imaging and were transferred to a Level I PTC during 2010 to 2013 (pre-campaign) and 2015 (post-campaign) were reviewed. Patient demographics, mode of transportation, ED length of stay, scanned body region, injury severity score, and trauma center level were analyzed. Median effective radiation dose (ERD) controlled for each variable, pre-campaign and post-campaign, was compared using Wilcoxon rank sum test. Results: Three hundred eighty-five children under 17 years were transferred from 45 and 48 hospitals, pre- and post-campaign. Most (43%) transferring hospitals were urban or critical access hospitals (30%). Pre- and post-campaign patient demographics were similar. We analyzed 482 and 398 CT scans pre- and post-campaign. Overall, median ERD significantly decreased from 3.80 to 2.80. Abdominal CT scan ERD declined significantly from 7.2 to 4.13 (P-value 0.03). Head CT scan ERD declined from 3.27 to 2.45 (P-value < 0.0001). Conclusion: A statewide, CT scan educational campaign contributed to ERD decline (lower dose scans and fewer repeat scans) among transferred injured children seen at PTCs. State-level interventions are feasible and can be effective in changing radiology provider practices. https://www.cambridge.org/core/product/identifier/S2059866121007937/type/journal_articlePediatric computed tomography scan protocolsradiation safetyeducational campaignradiation doseevaluation
spellingShingle Rosemary Nabaweesi
Chary Akmyradov
Mary E. Aitken
Phillip J. Kenney
Raghu H. Ramakrishnaiah
Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured children
Journal of Clinical and Translational Science
Pediatric computed tomography scan protocols
radiation safety
educational campaign
radiation dose
evaluation
title Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured children
title_full Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured children
title_fullStr Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured children
title_full_unstemmed Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured children
title_short Impact of a statewide computed tomography scan educational campaign on radiation dose and repeat CT scan rates for transferred injured children
title_sort impact of a statewide computed tomography scan educational campaign on radiation dose and repeat ct scan rates for transferred injured children
topic Pediatric computed tomography scan protocols
radiation safety
educational campaign
radiation dose
evaluation
url https://www.cambridge.org/core/product/identifier/S2059866121007937/type/journal_article
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