A tool adapted from the US could help Australian clinicians identify brain CT scan overuse and implement safer, higher-quality care in paediatric patients with atraumatic headache, a Victorian study suggests.
The study assessed whether a localised version of America’s “Overuse of CT scans for the evaluation of children with atraumatic headache” tool could accurately and feasibly detect patients receiving non-indicated scans in Australian healthcare settings.
It found the diagnostic code-dependent tool accurately identified atraumatic headache patients 95.3% of the time, with 601 relevant patients attending Melbourne’s Royal Children’s Hospital in 2017 and 2018. Of these, 98 received at least one CT scan, 14.1% of which were non-indicated.
This means that 2% of all atraumatic headache encounters received a non-indicated scan, Royal Children’s Hospital researcher Ms Yue Cherry Shi and her team wrote in Pediatric Emergency Care.
While valuable, the tool did have some feasibility issues, with clinicians needing to compare output with clinical notes, the authors wrote.
In some cases, diagnostic information was included in free-text rather than code fields, hindering patient detection. Additionally, some notes justified brain CT as “clinically indicated”, where codes might have suggested otherwise.