CME Information: Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma.

Background: Data suggest that clinicians, when evaluating pediatric patients with blunt head trauma, may be
overordering head computed tomography (CT). Prior decision instruments (DIs) aimed at aiding clinicians in safely
forgoing CTs may be paradoxically increasing CT utilization. This study evaluated a novel DI that aims for high
sensitivity while also improving specificity over prior instruments.
Methods: We conducted a planned secondary analysis of the NEXUS Head CT DI among patients less than 18
years old. The rule required patients satisfy seven criteria to achieve “low-risk” classification. Patients were
assigned “high-risk” status if they fail to meet one or more criteria. Our primary outcome was the ability of the
rule to identify all patients requiring neurosurgical intervention.
Results: The study enrolled 1,018 [more…]