Head CT Use Can Vary Widely Even Within a Single ER, Study Says

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Variation in head CT use may be unnecessarily overtaxing hospital resources and increasing costs to patients, according to a new study from Brigham and Women's Hospital and Harvard Medical School. On the heels of an ill-received CMS measure calling for limiting use of head CT in the interests of lowering patient radiation dose, lead author Luciano M. Prevedello said in a prepared statement that “even after accounting for a number of factors associated with ordering behavior, we found that greater than two fold variability in head CT use still persists.” Researchers combed 55,281 adult ER visits “at a large urban academic hospital throughout 2009.” Even after allowing for variation among patient ages, genders, disease categorization, degree of emergency, and the location of the ER, the rates at which they received head CT varied from 4.4 percent to 16.9 percent. Head CT was most commonly ordered for patients who are male, older, and in need of more urgent care. The likeliest patients to receive head CT were those demonstrating head trauma, stroke, and headache. The entire study is scheduled to be released in the April issue of the American Journal of Medicine.