Survey of physicians’ attitudes toward computerized tomography imaging for pediatric head trauma

<p>  Objective: The Medical Safety Committee of the Japanese Society of Child Neurology published “Recommendations for Criteria for Examining CT for Head Trauma in Children” (Recommendations) in 2019. Subsequently, revisions in the medical fees were made in 2020, and the change in requirements of medical fees related to CT examinations for pediatric head trauma was done. The present study aims to determine whether physicians are aware about the recommendations and the change in requirements of medical fees related to CT examinations for pediatric head trauma, and whether they apply the diagnostic algorithms for pediatric head trauma in Japan. We also identified factors related to the awareness and application of the diagnostic algorithms. Methods: We surveyed 7,590 physicians who treat pediatric head trauma in Japan through a web-based questionnaire. Statistical analysis was performed using a decision tree analysis and logistic regression model. Results: A total of 1,073 physicians participated in the survey (14.1% response rate). The survey respondents were male (75.2%), female (24.8%), pediatricians (65.6%), neurosurgeons (19.0%), pediatric emergency physicians (6.1%), pediatric surgeons (5.3%), radiologists (3.2%), and other physicians (0.8%). 64.6% of the physicians acknowledged the recommendations, and the factors related to this were department and position (p<0.001). Only 14.5% of physicians recognized the additional requirements. Moreover, only two-thirds of these physicians were able to implement them at their hospitals. The physicians who treated more than 6 trauma cases per month and worked at clinical training hospitals recognized the additional requirements and application of the diagnostic algorithms (p<0.001). Conclusion: The diagnostic algorithms for pediatric head trauma should be utilized in medical practice to reduce radiation exposure in children. It is necessary to widely inform diagnostic algorithm to physicians through various media since the previous recommendations and revisions in the medical fees for head trauma have not been sufficient.</p>