Cain MR, et al. - In a free-standing children's hospital system, the researchers assessed Emergency Department use and outcomes of neuroimaging for a headache. Data reported that the observed Emergency Department imaging rate was 26.5 times higher than the positive result rate. The findings suggested that there was room to decrease unnecessary neuroimaging. It was noted that associations for abnormal examination and new headache type were consistent with the American Academy of Neurology clinical imaging recommendations. As per data, the increased odds of imaging white patients suggests a bias that should be addressed.

Methods

• Participants in the study were children aged 6-18 years who presented to the Emergency Department with a chief complaint of headache from September 2015 to September 2016.
• Researchers performed standardized data collection in real time, involving telephone follow-up as needed, and imaging outcome was determined through a chart review.
• They analyzed the relationships between clinically important patient characteristics and neuroimaging using multivariable logistic regression.

Results

• According to the findings obtained, out of 294 recruited patients, 53 (18%) had neuroimaging (computed tomography or magnetic resonance imaging) and 2 (0.7%) had clinically important intracranial findings.
• Data reported that presenting with abnormal neurologic examination findings (OR, 11.55; 95% CI, 3.24-41.22), no history of similar headaches (OR, 2.13; 95% CI, 1.08-4.18), and white race (OR, 3.04; 95% CI, 1.51-6.12) were significantly linked to an increased odds of undergoing imaging in multivariable regression models.