Research Letters | Comparative Effectiveness Research

Association Between Parental Preference and Head Computed Tomography in Children With Minor Blunt Head Trauma

Yasushi Ishida, MD, PhD; Atsushi Manabe, MD, PhD; Aya Oizumi, RHIA; Norio Otani, MD; Michio Hirata, MD; Kevin Urayama, PhD, MPH; Yukihisa Saida, MD; Isao Kusakawa, MD, PhD; Tsuguya Fukui, MD, PhD, MPH
JAMA Pediatr. 2013;167(5):491-492. doi:10.1001/jamapediatrics.2013.1448.
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Natale et al1 recently reported that race/ethnicity is independently associated with head computed tomography (CT) use among children with minor blunt head trauma. They showed parental anxiety as an important factor influencing head CT orders in non-Hispanic white children regardless of brain injury risk.1 In a Japanese pediatric cohort of patients with minor blunt head trauma, we conducted a study with similar objectives attempting to identify factors that influence a physician's decision to order a head CT in children.

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Figure. A graphical representation of the Chi-squared Automatic Interaction Detection (CHAID) analysis. Through a process of recursive partitioning based on degree of statistical significance of the χ2 tests for independence, the CHAID algorithm evaluated which explanatory variables (eg, parental preference and brain injury risk categories), if split, most “explain” the dependent variable (head computed tomography [CT] scan). Cut points for child's age were selected by the CHAID algorithm.




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