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Canadian CT head rule

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https://www.readbyqxmd.com/read/29095182/reducing-unnecessary-head-computed-tomography-in-mild-traumatic-brain-injury
#1
Nathaniel John Webster, Nathan Moore, Felicia Stewart
There is growing concern about the frequency of computed tomographic (CT) scans performed for evaluation of adults with suspected mild traumatic brain injury. The Canadian CT Head Rule and the New Orleans Criteria are the most studied head CT decision tools that aid providers in determining which patients do not require a CT scan. This article examines recent research to determine which of these tools has proven to be the most effective at safely reducing the use of head CT scans. The reviewed studies concluded that both the Canadian CT Head Rule and the New Orleans Criteria had similar sensitivities, but the Canadian CT Head Rule showed superior specificity in predicting the presence of a clinically significant brain injury...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29068630/calculated-decisions-canadian-ct-head-injury-trauma-rule
#2
Daniel Runde
No abstract text is available yet for this article.
October 25, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28991814/management-of-traumatic-brain-injury-in-the-emergency-department-guideline-adherence-and-patient-safety
#3
Tomas Vedin, Marcus Edelhamre, Mathias Karlsson, Michael Bergenheim, Per-Anders Larsson
BACKGROUND: Traumatic brain injury is a common reason not only for emergency visits worldwide but also for significant morbidity and mortality. Several clinical guidelines exist but adherence is generally low. AIM: To study attitudes toward computed tomography of the head among emergency department Change to physicians throughout the article who manage patients with trauma to the head and doctors' adherence to guidelines. METHODS: Quantitative questionnaire study with questionnaires collected over 3 months before introduction of new guidelines...
October 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28958987/tablet-based-patient-centered-decision-support-for-minor-head-injury-in-the-emergency-department-pilot-study
#4
Navdeep Singh, Erik Hess, George Guo, Adam Sharp, Brian Huang, Maggie Breslin, Edward Melnick
BACKGROUND: The Concussion or Brain Bleed app is a clinician- and patient-facing electronic tool to guide decisions about head computed tomography (CT) use in patients presenting to the emergency department (ED) with minor head injury. This app integrates a patient decision aid and clinical decision support (using the Canadian CT Head Rule, CCHR) at the bedside on a tablet computer to promote conversations around individualized risk and patients' specific concerns within the ED context...
September 28, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28739290/implementation-of-the-canadian-ct-head-rule-and-its-association-with-use-of-computed-tomography-among-patients-with-head-injury
#5
Adam L Sharp, Brian Z Huang, Tania Tang, Ernest Shen, Edward R Melnick, Arjun K Venkatesh, Michael H Kanter, Michael K Gould
STUDY OBJECTIVE: Approximately 1 in 3 computed tomography (CT) scans performed for head injury may be avoidable. We evaluate the association of implementation of the Canadian CT Head Rule on head CT imaging in community emergency departments (EDs). METHODS: We conducted an interrupted time-series analysis of encounters from January 2014 to December 2015 in 13 Southern California EDs. Adult health plan members with a trauma diagnosis and Glasgow Coma Scale score at ED triage were included...
July 21, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28700585/validation-of-the-sensitivity-of-the-national-emergency-x-radiography-utilization-study-nexus-head-computed-tomographic-ct-decision-instrument-for-selective-imaging-of-blunt-head-injury-patients-an-observational-study
#6
William R Mower, Malkeet Gupta, Robert Rodriguez, Gregory W Hendey
BACKGROUND: Clinicians, afraid of missing intracranial injuries, liberally obtain computed tomographic (CT) head imaging in blunt trauma patients. Prior work suggests that clinical criteria (National Emergency X-Radiography Utilization Study [NEXUS] Head CT decision instrument [DI]) can reliably identify patients with important injuries, while excluding injury, and the need for imaging in many patients. Validating this DI requires confirmation of the hypothesis that the lower 95% confidence limit for its sensitivity in detecting serious injury exceeds 99...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28692515/criteria-for-performing-cranial-computed-tomography-for-chinese-patients-with-mild-traumatic-brain-injury-canadian-computed-tomography-head-rule-or-new-orleans-criteria
#7
Xiao-Feng Yang, Yuan-Yuan Meng, Liang Wen, Hao Wang
Computed tomography (CT) provides the primary diagnostic evidence for traumatic brain injury (TBI), but few positive traumatic findings are discovered in patients with mild TBI. In China, there are no existing criteria for selecting patients with mild TBI to undergo CT, and almost all of these patients undergo cranial CT in the emergency department. This retrospective study was performed to evaluate the necessity of cranial CT among patients with mild TBI, as well as the feasibility of 2 popular criteria (Canadian CT head rule [CCHR] and New Orleans Criteria [NOC]) in China...
September 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28540393/computed-tomography-scans-of-the-head-for-adult-patients-with-minor-head-injury-are-clinical-decision-rules-a-necessary-evil
#8
Desmond Wei Tan, Annabelle Mei En Lim, Daniel Yuxuan Ong, Li Lee Peng, Yiong Huak Chan, Irwani Ibrahim, Win Sen Kuan
INTRODUCTION: This study aimed to evaluate compliance with and performance of the Canadian Computed Tomography Head Rule (CCHR), and its applicability in the local adult population with minor head injury. METHODS: We conducted a retrospective study of consecutive patients who presented to the adult emergency department (ED) with minor head injury over six months. Data on predictor variables indicated in the CCHR was collected and compliance with the CCHR assessed by comparing the recommendations for head computed tomography (CT) scans to its actual usage...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#9
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28268778/a-machine-learning-based-approach-for-identifying-traumatic-brain-injury-patients-for-whom-a-head-ct-scan-can-be-avoided
#10
Somayeh Molaei, Frederick K Korley, S M Reza Soroushmehr, Hayley Falk, Haris Sair, Kevin Ward, Kayvan Najarian
Head CT scan is more often used to evaluate patients with suspected traumatic brain injury (TBI). However, the use of head CT scans in evaluating TBI is costly with low value endeavor. In this paper, we propose a new algorithm and a set of features to help clinicians determine which patients evaluated for TBI need a head CT scan using cost sensitive random forest (CSRF) classifier. We show that random forest (RF) and CSRF are useful methods for identifying patients likely to have a positive head CT scan. The proposed algorithm has superior diagnostic accuracy in comparison to the Canadian head CT algorithm, which is currently the most accurate and widely used algorithm for determining which TBI patients need a head CT scan...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#11
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
https://www.readbyqxmd.com/read/28226969/a-machine-learning-based-approach-for-identifying-traumatic-brain-injury-patients-for-whom-a-head-ct-scan-can-be-avoided
#12
Somayeh Molaei, Frederick K Korley, S M Reza Soroushmehr, Hayley Falk, Haris Sair, Kevin Ward, Kayvan Najarian, Somayeh Molaei, Frederick K Korley, S M Reza Soroushmehr, Hayley Falk, Haris Sair, Kevin Ward, Kayvan Najarian, Frederick K Korley, Hayley Falk, Kevin Ward, S M Reza Soroushmehr, Haris Sair, Kayvan Najarian, Somayeh Molaei
Head CT scan is more often used to evaluate patients with suspected traumatic brain injury (TBI). However, the use of head CT scans in evaluating TBI is costly with low value endeavor. In this paper, we propose a new algorithm and a set of features to help clinicians determine which patients evaluated for TBI need a head CT scan using cost sensitive random forest (CSRF) classifier. We show that random forest (RF) and CSRF are useful methods for identifying patients likely to have a positive head CT scan. The proposed algorithm has superior diagnostic accuracy in comparison to the Canadian head CT algorithm, which is currently the most accurate and widely used algorithm for determining which TBI patients need a head CT scan...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/27836434/overuse-of-head-ct-examinations-for-the-investigation-of-minor-head-trauma-analysis-of-contributing-factors
#13
Eyal Klang, Arkadi Beytelman, Dan Greenberg, Jacob Or, Larisa Guranda, Eli Konen, Eyal Zimlichman
PURPOSE: The aim of this study was to estimate the amount of CT studies performed in the emergency department of a tertiary hospital that are not indicated by Canadian CT Head Rule (CCHR) guidelines and to analyze factors that contribute to unnecessary examinations. METHODS: A total of 955 brain CT examinations performed for minor head injuries were randomly retrospectively selected. Medical records were assessed for the following parameters: demographics, cause of head trauma, and referring physician's seniority and specialty...
February 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27745699/comparison-of-the-canadian-ct-head-rule-and-the-new-orleans-criteria-in-patients-with-minor-head-injury-in-a-spanish-hospital
#14
Joaquín Valle Alonso, Francisco Javier Fonseca Del Pozo, Manuel Vaquero Álvarez, Elisa Lopera Lopera, Marisol Garcia Segura, Ricardo García Arévalo
BACKGROUND AND OBJECTIVE: To compare two scales for assessment of patients with mild head injury. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) according to their diagnostic accuracy in patients attending an emergency department, and to determine the most important predictive values. METHOD: Cross-sectional study in a first-level Hospital in the period of January 2011 to January 2013. Patients with mild head injury criteria were included. All the patients underwent a computed tomography (CT) of the head as part of internal protocol and the CCHR and NOC criteria were recorded for each patient...
December 16, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27717240/attitudes-toward-evidence-based-clinical-decision-support-tools-to-reduce-exposure-to-ionizing-radiation-the-canadian-ct-head-rule
#15
Raymond Zakhari, Susan E Sterrett
BACKGROUND AND PURPOSE: A large degree of variation in clinical practice exists among clinicians evaluating and treating individuals with minor head injuries. Noncontrast head computerized tomography (CT) scans are commonly used to assess for intracranial damage in patients presenting with head injury. This practice is not supported by the evidence and poses harm to patients by increasing exposure to ionizing radiation. This form of radiation exposure increases the risk of developing cancers over the course of the individual's life, and further strains the limited resources of the healthcare system...
December 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27617902/big-versus-small-data-and-the-generalizability-of-the-rate-of-computed-tomography-overuse-in-minor-head-injury
#16
LETTER
Edward R Melnick
No abstract text is available yet for this article.
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27473552/computed-tomography-use-for-adults-with-head-injury-describing-likely-avoidable-emergency-department-imaging-based-on-the-canadian-ct-head-rule
#17
Adam L Sharp, Ganesh Nagaraj, Ellen J Rippberger, Ernest Shen, Clifford J Swap, Matthew A Silver, Taylor McCormick, David R Vinson, Jerome R Hoffman
BACKGROUND: Millions of head computed tomography (CT) scans are ordered annually, but the extent of avoidable imaging is poorly defined. OBJECTIVES: The objective was to determine the prevalence of likely avoidable CT imaging among adults evaluated for head injury in 14 community emergency departments (EDs) in Southern California. METHODS: We conducted an electronic health record (EHR) database and chart review of adult ED trauma encounters receiving a head CT from 2008 to 2013...
January 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27401915/age-is-not-associated-with-intracranial-haemorrhage-in-patients-with-mild-traumatic-brain-injury-and-oral-anticoagulation
#18
Thomas C Sauter, Stephan Ziegenhorn, Sufian S Ahmad, Wolf E Hautz, Meret E Ricklin, Alexander Benedikt Leichtle, Georg-Martin Fiedler, Dominik G Haider, Aristomenis K Exadaktylos
BACKGROUND: Patients admitted to emergency departments with traumatic brain injury (TBI) are commonly being treated with oral anticoagulants. In contrast to patients without anticoagulant medication, no guidelines, scores or recommendations exist for the management of mild traumatic brain injury in these patients. We therefore tested whether age as one of the high risk factors of the Canadian head CT rule is applicable to a patient population on oral anticoagulants. METHODS: This cross-sectional analysis included all patients with mild TBI and concomitant oral anticoagulant therapy admitted to the Emergency Department, Inselspital Bern, Switzerland, from November 2009 to October 2014 (n = 200)...
June 1, 2016: Journal of Negative Results in Biomedicine
https://www.readbyqxmd.com/read/27026873/canadian-ct-head-rule-and-new-orleans-criteria-in-mild-traumatic-brain-injury-comparison-at-a-tertiary-referral-hospital-in-japan
#19
Daddy Mata-Mbemba, Shunji Mugikura, Atsuhiro Nakagawa, Takaki Murata, Yumiko Kato, Yasuko Tatewaki, Kei Takase, Shigeki Kushimoto, Teiji Tominaga, Shoki Takahashi
We compared Canadian computed tomography (CT) head rule (CCHR) and New Orleans Criteria (NOC) in predicting important CT findings in patients with mild traumatic brain injury (TBI). We included 142 consecutive patients with mild TBI [Glasgow coma scale (GCS) 13-15] who showed at least one of the risk factors stated in the CCHR or the NOC. We introduced two scores: a Canadian from the CCHR and a New Orleans from the NOC. A patient's score represented a sum of the number of positive items. We examined the relationship between scores or items and the presence of important CT findings...
2016: SpringerPlus
https://www.readbyqxmd.com/read/26947778/scalp-hematoma-characteristics-associated-with-intracranial-injury-in-pediatric-minor-head-injury
#20
Emma C M Burns, Anne M Grool, Terry P Klassen, Rhonda Correll, Anna Jarvis, Gary Joubert, Benoit Bailey, Laurel Chauvin-Kimoff, Martin Pusic, Don McConnell, Cheri Nijssen-Jordan, Norm Silver, Brett Taylor, Martin H Osmond
OBJECTIVES: Minor head trauma accounts for a significant proportion of pediatric emergency department (ED) visits. In children younger than 24 months, scalp hematomas are thought to be associated with the presence of intracranial injury (ICI). We investigated which scalp hematoma characteristics were associated with increased odds of ICI in children less than 17 years who presented to the ED following minor head injury and whether an underlying linear skull fracture may explain this relationship...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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