AJM in the News: Overuse of Head CT Scans?

Are emergency room physicians over-prescribing head CT scans for atraumatic headaches?

The April 2012 of The American Journal of Medicine features research pointing to wide variability in the use of head CT scans.

A group of Harvard researchers hypothesized that there is a significant variation in physician head CT use even within a single facility, and they were right.

“Even after accounting for a number of factors associated with ordering behavior, we found that greater than 2-fold variability in head CT use still persists,” explains lead author Luciano M. Prevedello, MD, Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women’s Hospital, and Harvard Medical School.

The study looked at whether a head CT was performed in 55,281 patient visits to the adult-only emergency department at a large urban academic hospital throughout 2009. Patient variables included patient age, gender, severity of the emergency, emergency department location, and disease categorization. Physician-specific variables included years in practice and gender.

Overall, 8.9% of the visits generated head CT examinations. Rates per physician ranged from 4.4% to 16.9%.

Imaging has been identified as one of the key drivers of increased healthcare costs. Strategies to reduce such variation in head CT use may reduce cost and improve quality of care.

Several news outlets followed up on this story in the Journal.

Here is a link to the research study.
Variation in Use of Head Computed Tomography by Emergency Physicians