Hospital-Level Factors Associated With Use of Pediatric Radiation Dose-Reduction Protocols for Head CT: Results From a National Survey

Abstract

Objectives To examine hospital-level factors associated with the use of a dedicated pediatric dose-reduction protocol and protective shielding for head CT in a national sample of hospitals. Materials and Methods A mixed-mode (online and paper) survey was administered to a stratified random sample of U.S. community hospitals (N=751). Respondents provided information on pediatric head CT scanning practices, including use of a dose-reduction protocol. Modified Poisson regression analyses describe the relative risk (RR) of not reporting the use of a pediatric dose reduction protocol or protective shielding; multivariable analyses adjust for census region, trauma level, children’s hospital status, and bed size. Results Of hospitals that were contacted, 38 were ineligible (no CT scanner, hospital closed, do not scan infants), 1 refused, and 253 responded (35.5% response rate). Across all hospitals, 92.6% reported using a pediatric dose reduction protocol. Modified Poisson regression showed that small hospitals (0–50 beds) were 20% less likely to report using a protocol than large hospitals (>150 beds) (RR: 0.80, 95% CI: 0.65–0.99; adjusted for covariates). Teaching hospitals were more likely to report using a protocol (RR: 1.10, 95% CI: 1.02–1.19; adjusted for covariates). After adjusting for covariates, children’s hospitals were significantly less likely to report using protective shielding than non-children’s hospitals (RR: 0.64, 95% CI: 0.56–0.73), though this may be due to more advanced scanner type. Conclusion Results from this study provide guidance for tailored educational campaigns and quality improvement interventions to increase the adoption of pediatric dose-reduction efforts.

Variation in CT Pediatric Head Examination Radiation Dose: Results From a National Survey

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