Evidence map›Paper›PMID 41504833›Full record

ArticleEmergency radiology2026

Appropriateness of imaging requests for pediatric traumatic brain injury in the emergency department: a retrospective cross-sectional study.

Esteban A Vásquez Carpio, Belén Báez, Matías Huidobro, Claudia Olivares, Lía Rodriguez, Marcelo Castro, Tamara Ramírez

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Emergency radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Esteban A Vásquez CarpioINDISA Clinical Campus, Department of Radiology, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile. esteban.avc@gmail.com.ORCID http://orcid.org/0009-0007-2862-7007
Belén BáezINDISA Clinical Campus, Department of Radiology, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile.ORCID http://orcid.org/0009-0009-6609-1332
Matías HuidobroINDISA Clinical Campus, Department of Radiology, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile.ORCID http://orcid.org/0009-0009-4407-1760
Claudia OlivaresINDISA Clinical Campus, Department of Radiology, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile.ORCID http://orcid.org/0009-0001-4056-2863
Lía RodriguezINDISA Clinical Campus, Department of Radiology, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile.ORCID http://orcid.org/0009-0008-7298-6290
Marcelo CastroINDISA Clinical Campus, Department of Radiology, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile.ORCID http://orcid.org/0000-0002-0113-820X
Tamara RamírezINDISA Clinical Campus, Department of Radiology, School of Medicine, Universidad Andrés Bello, Av. Santa María 1810, Providencia, Santiago, Chile.ORCID http://orcid.org/0009-0001-8274-7516

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPediatric traumatic brain injury (TBI) accounts for a significant proportion of emergency department (ED) visits, with an estimated global incidence of up to 200 cases per 100,000 children each year. Despite clinical guidelines, imaging is often overused, particularly in mild cases, exposing children to unnecessary radiation. In Latin America, evidence regarding the appropriateness of imaging requests (AIR) and their diagnostic value remains scarce.

objectiveTo assess the association between the AIR and final radiologic findings in traumatic brain injury, and to explore predictors through multivariable analysis.

methodsThis retrospective, multicentric, cross-sectional study included 719 neuroimaging studies (CT and skull radiography -SR-) performed in 2023 at two high-complexity private hospitals in Santiago, Chile. AIR was classified using the ACR Appropriateness Criteria® and the PECARN algorithm. Confirmatory findings included hemorrhages, skull fractures, and other traumatic lesions. Exploratory multivariable models were applied to evaluate factors associated with final diagnosis.

resultsOnly 2.9% of imaging requests were deemed appropriate. Among CTs (n = 317), the adjusted probability of a confirmatory result was 48.0% (95% CI: 26.3-69.8) for appropriate requests versus 7.0% (95% CI: 4.1-9.9) for inappropriate ones, an absolute difference of 41 percentage points (p < 0.01). Inappropriate requests were associated with a 13-fold lower relative probability of identifying clinically relevant findings. All SRs were considered inappropriate and had a diagnostic yield of only 1%.

conclusionA significant gap exists between clinical practice and guideline-based imaging for pediatric TBI in Chile. Reinforcing validated decision tools may help optimize imaging use and minimize unnecessary radiation exposure.

Indexed as

Brain Injuries, TraumaticEmergency Service, HospitalNeuroimagingTomography, X-Ray ComputedUnnecessary ProceduresAdolescentChildChild, PreschoolChileCross-Sectional StudiesFemaleHumansInfantMaleRetrospective StudiesAppropriateBrain injuries,Child;Emergency service,Hospital;Radiography;Tomography,Traumatic;X- ray computed;

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.