Featured Research

from universities, journals, and other organizations

'Incidental findings' rare but significant events in pediatric CT scans

Date:
September 12, 2013
Source:
University of California - Davis Health System
Summary:
The largest study of computed tomographic scans taken in emergency departments across the country for children with head injuries describes the prevalence of "incidental findings" -- results that were not expected from the injury -- and categorizes them by urgency.

The largest study of computed tomographic (CT) scans taken in emergency departments across the country for children with head injuries describes the prevalence of "incidental findings" -- results that were not expected from the injury -- and categorizes them by urgency.

Related Articles


The article, titled "Incidental findings in children with blunt head trauma evaluated with cranial CT scans," was published in the August issue of Pediatrics, and provides a context for doctors in emergency departments who encounter these situations.

"Incidental findings are a rare but significant event," said Nathan Kuppermann, professor and chair of emergency medicine at the UC Davis Medical Center and principal investigator of the study. "It is important for doctors to look for abnormalities other than what they expect to find and to be prepared to interpret and communicate these findings to families."

The study involved nearly 44,000 children seen for a head injury in 25 hospital emergency departments nationwide. Nearly 16,000 had CT scans to evaluate an injury, and about 4 percent of the scans revealed incidental findings ranging from enlarged tonsils to life-threatening cancers. Children with a known pre-existing brain abnormality were excluded from the analysis.

The researchers also stratified the incidental findings into three categories: those that needed immediate evaluation or treatment, those that needed appropriate timely outpatient follow up, and those that merited further investigation only if the problems were causing symptoms. Only 0.1 percent of the overall sample of CTs fell into the most serious category.

"Incidental findings" rare but significant events in pediatric CT scans

Due to the small percentage of patients with the most urgent incidental findings, the study authors do not recommend any changes to current CT scan guidelines. They believe emergency medicine physicians should continue to perform CT scans in children as is medically justified for their injury because a CT scan entails a small but known long-term risk of cancer from radiation exposure.

Genetic analysis, sophisticated imaging studies and other high-technology tests have made it possible to gain information that neither the doctor nor patient expects. Knowing what to do with these findings, especially if they are likely to be inconsequential to a patient's health, can be a dilemma for physicians. The authors believe physicians should weigh the patient's right to know against financial costs and potential negative health effects from anxiety, additional testing and possibly even unnecessary treatment brought on by learning of the findings.

"Because the practice of medicine has embraced technologies that provide information beyond the actual clinical question, a need to develop strategies to handle unexpected information now exists," said Alexander Rogers, assistant professor of pediatric emergency medicine at the University of Michigan Health System and lead author of the study. "Particularly in the emergency room, doctors must decide quickly whether and how to disclose information to a family with whom they have no prior relationship and do not know what their response is likely to be."

The study is by far the largest pediatric multicenter description of the prevalence of incidental findings on head CT scans. It also is a secondary analysis of a study that was designed to establish a decision rule for determining which children who present to the emergency room with a head injury should have a CT scan to evaluate it. The resulting Pediatric Head Injury/Trauma Algorithm has become standard in emergency departments worldwide and has helped reduce the number of unnecessary CT scans in children. Both studies were part of the Pediatric Emergency Care Applied Research Network (PECARN), the only federally-funded pediatric emergency medicine research network. With participating academic and urban hospitals across the country, the network has access to a large number of demographically diverse populations of children being seen in emergency departments.

"The large size of this study enhances the value and generalizability of our findings," said Kuppermann, who is the founding chair of PECARN and served as its chair until 2008. "Without the large, multicenter network provided by PECARN, we would be unable to have undertaken such a definitive study."


Story Source:

The above story is based on materials provided by University of California - Davis Health System. Note: Materials may be edited for content and length.


Journal Reference:

  1. A. J. Rogers, C. O. Maher, J. E. Schunk, K. Quayle, E. Jacobs, R. Lichenstein, E. Powell, M. Miskin, P. Dayan, J. F. Holmes, N. Kuppermann. Incidental Findings in Children With Blunt Head Trauma Evaluated With Cranial CT Scans. PEDIATRICS, 2013; 132 (2): e356 DOI: 10.1542/peds.2013-0299

Cite This Page:

University of California - Davis Health System. "'Incidental findings' rare but significant events in pediatric CT scans." ScienceDaily. ScienceDaily, 12 September 2013. <www.sciencedaily.com/releases/2013/09/130912093741.htm>.
University of California - Davis Health System. (2013, September 12). 'Incidental findings' rare but significant events in pediatric CT scans. ScienceDaily. Retrieved October 30, 2014 from www.sciencedaily.com/releases/2013/09/130912093741.htm
University of California - Davis Health System. "'Incidental findings' rare but significant events in pediatric CT scans." ScienceDaily. www.sciencedaily.com/releases/2013/09/130912093741.htm (accessed October 30, 2014).

Share This



More Health & Medicine News

Thursday, October 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Fauci Says Ebola Risk in US "essentially Zero"

Fauci Says Ebola Risk in US "essentially Zero"

AP (Oct. 30, 2014) NIAID Director Anthony Fauci said the risk of Ebola becoming an epidemic in the U.S. is essentially zero Thursday at the Washington Ideas Forum. He also said an Ebola vaccine will be tested in West Africa in the next few months. (Oct. 30) Video provided by AP
Powered by NewsLook.com
Nurse Defies Ebola Quarantine With Bike Ride

Nurse Defies Ebola Quarantine With Bike Ride

AP (Oct. 30, 2014) A nurse who vowed to defy Maine's voluntary quarantine for health care workers who treated Ebola patients followed through on her promise Thursday, leaving her home for an hour-long bike ride. (Oct. 30) Video provided by AP
Powered by NewsLook.com
Microsoft Launches Fitness Band After Accidental Reveal

Microsoft Launches Fitness Band After Accidental Reveal

Newsy (Oct. 30, 2014) Microsoft accidentally revealed its upcoming fitness band on Wednesday, so the company went ahead and announced it. Video provided by Newsy
Powered by NewsLook.com
Bracing to Meet a Killer: Aid Workers Prep for Ebola in Geneva

Bracing to Meet a Killer: Aid Workers Prep for Ebola in Geneva

AFP (Oct. 30, 2014) At the International Federation of Red Cross and Red Crescent Societies, around 30 doctors, nurses, lab technicians and water and sanitation workers are gathered for a crash-course in how to safely deal Ebola. Duration: 01:31 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins