دورية أكاديمية
أعرض في EDS

Overuse of computed tomography for mild head injury: A systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Overuse of computed tomography for mild head injury: A systematic review and meta-analysis.
المؤلفون: Saran M; Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran., Arab-Zozani M; Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran., Behzadifar M; Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran., Gholami M; Department of Medical Physics, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran., Azari S; Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran., Bragazzi NL; Human Nutrition Unit Department of Food and Drugs, University of Parma Medical School, Parma, Italy., Behzadifar M; Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
المصدر: PloS one [PLoS One] 2024 Jan 11; Vol. 19 (1), pp. e0293558. Date of Electronic Publication: 2024 Jan 11 (Print Publication: 2024).
نوع المنشور: Meta-Analysis; Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Tomography, X-Ray Computed* , Craniocerebral Trauma*/diagnostic imaging, Humans ; Child ; Cross-Sectional Studies ; Canada ; Glasgow Coma Scale
مستخلص: Background: Computed tomography (CT) scan is a common imaging technique used to evaluate the severity of a head injury. The overuse of diagnostic interventions in the health system is a growing concern worldwide. Objectives: The aim of this systematic review is to investigate the rate of CT scan overuse in cases of mild head injury.
Methods: Eligibility criteria: We encompassed observational studies-either designed as cohort, case-control, or cross-sectional investigations-that reported on CT scan overuse rates for mild head injuries. Studies had to be published in peer-reviewed, English-language sources and provide full content access Information sources: Web of Sciences, Scopus, Medline via PubMed, the Cochrane Library and Embase were searched from inception until April 1, 2023. Studies were included if reporting the overuse of CT scans for mild head injuries using validated criteria. Risk of bias: We used the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool to evaluate the risk bias assessment of included studies. Two independent reviewers evaluated the eligibility of studies, extracted data, and assessed study quality by using the Newcastle-Ottawa Scale. Synthesis of results: Overuse estimates were calculated using a random-effects model. Subgroup analyses were performed to investigate any sources of heterogeneity. Point rate of overuse of CT scans for mild head injuries was the main outcome measured as percentage point estimates with corresponding 95% CIs.
Results: Included studies: Of the 913 potentially relevant studies identified, eight studies were selected for the final analysis. Synthesis of results: The pooled rate of CT scan overuse in patients with mild head injury was found to be 27% [95% CI: 16-43; I2 = 99%]. The rate of CT scan overuse in mild head injury cases varied depending on the criteria used. The rate of CT scan overuse was 37% [95% CI: 32-42; I2 = 0%] with the Glasgow Coma Scale (GCS), 30% [95% CI: 16-49; I2 = 99%] with the Canadian computed tomography head rule, and 10% [95% CI: 8-14; I2 = 0%] with the Pediatric Emergency Care Applied Research Network criterion (PERCAN). Based on subgroup analyses, the rate of CT scan overuse in mild head injury cases was observed to be 30% with the Canadian computed tomography head rule criterion, 43% with the National Institute for Health and Clinical Excellence criterion, and 18% with the New Orleans criterion.
Conclusion: Limitations of evidence: The restricted number of included studies may impact generalizability. High heterogeneity was observed, leading to subgroup analyses based on age, assessment criteria, and study region. Absent data on overuse causes hinders drawing conclusions on contributing factors. Furthermore, this study solely addressed overuse rates, not associated harm or benefits. Interpretation: The overuse of CT scans in mild head injury patients is concerning, as it can result in unnecessary radiation exposure and higher healthcare costs. Clinicians and policymakers should prioritize the implementation of guidelines to reduce unnecessary radiation exposure, healthcare costs, and potential harm to patients.
Trial Registration: The study protocol of this review was registered in PROSPERO under the identification code CRD42023416080. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023416080.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Saran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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تواريخ الأحداث: Date Created: 20240111 Date Completed: 20240115 Latest Revision: 20240415
رمز التحديث: 20240416
مُعرف محوري في PubMed: PMC10783716
DOI: 10.1371/journal.pone.0293558
PMID: 38206917
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0293558