Anderson KT, et al. - In this retrospective cohort study including 22,333 children who underwent appendectomies in 2015–2016 at National Surgical Quality Improvement Program for Pediatrics (NSQIP-P) hospitals, researchers evaluated the variables associated with preoperative computed tomography (CT) use in pediatric appendectomy patients. Observations revealed that patient characteristics were associated with different imaging practices, however, presentation at a referral, nonchildren's hospital was noted to be the strongest predictor of CT use in children with appendicitis. Transferred patients frequently underwent reimaging at NSQIP-P hospitals, thus no reduced CT use was noted in NSQIP-P hospitals. In order to sustain reduction in CT use and mitigate unnecessary imaging, novel strategies are required for all hospital types.