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Decision Support Can Help Family Doctors Cut Radiation Exposure

Decrease in CT ordering for those who viewed guidelines, then reviewed radiation information

TUESDAY, May 12, 2015 (HealthDay News) -- Point-of-care decision support can help family physicians select imaging that lowers pediatric radiation exposure and is in accordance with current guidelines, according to a study published in the May-June issue of the Journal of the American Board of Family Medicine.

Christopher W. Bunt, M.D., from the Uniformed Services University in Bethesda, Md., and colleagues conducted a double-blind, randomized simulation involving family physicians in the Military Health System. Initially, participants reviewed a pediatric hematuria scenario and chose imaging without decision support. They were then randomized to receive imaging-appropriateness guidelines followed by estimated radiation exposure information, or vice versa. After each step, imaging selections were required.

The researchers found that after viewing the guidelines, the first arm increased computed tomography (CT) ordering (P = 0.008), but they decreased CT ordering after reviewing radiation exposure information (P = 0.007). Radiation information decreased CT and plain film use in the second arm (P = not significant), with an increase in ultrasound and CT use after guideline presentation (P = 0.05).

"Decision support during a simulated pediatric scenario helped family physicians select imaging that lowered radiation exposure and was aligned with current guidelines, especially when presented with radiation information after guideline review," the authors write.

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