Childhood Radiation Exposure Can Be Reduced Significantly Using EMR Decision Support

The results of a study to find ways to reduce the pediatric radiation burden have been published in the May 8, 2015, issue of the Journal of the American Board of Family Medicine.

The study included 115 physicians from 17 US military family medicine training programs, and aimed to find whether an existing clinical decision support system, and the order in which information was presented would impact physician imaging choices. The system included a number of decision enhancement tools in the clinical workflow.

The study was carried out by researchers at the US Uniformed Services University of the Health Sciences (USU; Bethesda, MD, USA), the Cincinnati Children’s Hospital Medical Center (Cincinnati, OH, USA), the US National Library of Medicine (NLM; Bethesda, MD, USA), and the Clemson University (Clemson, SC, USA).

According to the researchers up to 40% of Computed Tomography (CT) scans are unnecessary. When children are exposed to unnecessary ionizing radiation their lifetime malignancy risk increases significantly

Imaging guidelines and clinical decision support systems guiding physicians in the appropriate use of medical imaging are often adopted inconsistently, and are mostly unavailable for children.

To improve the physician’s understanding of radiation doses from common imaging modalities the researchers used American College of Radiology (ACR) Appropriateness Criteria for pediatric clinical scenarios, and looked at how decision support on estimated radiation dose and current imaging guidelines in the Electronic Medical Record (EMR) influenced the selection of pediatric imaging modalities.

The results of the study showed that decision support changed the physicians’ choice of imaging modality. As a result ultrasound, which has no ionizing radiation, became the initial imaging modality of choice for more than 70% of the physicians instead of CT, Magnetic Resonance Imaging (MRI), and multiple types of X-Ray systems.

US Air Force Major, Dr. Christopher W. Bunt, said, “Busy clinicians in the civilian sector or in the military welcome information that helps them make a quick, safe and evidence-based decision. This study provides them with evidence that the information helps save kids from unnecessary radiation exposure. As a parent, I want my kids to receive the imaging studies that they need to diagnose and treat illness or injury. Making sure that these decisions are supported by evidence and are safe for my children is extremely important.”

Related Links:
USU
Cincinnati Children’s Hospital Medical Center
US National Library of Medicine