By necessity, the study focused on the numbers and types of procedures that were performed, and did not calculate specific doses of radiation that were received by each child. Data to perform such calculations are limited in children and are part of ongoing work by the team.
"What we've tried to do is raise awareness of the issue and start a national dialogue by identifying the overall scope of the problem," Dorfman says." One limitation of this type of analysis is that the clinical appropriateness of the tests could not be determined, he adds.
"The next step is to better understand when these tests really add value to the care of a child and when they do not," Dorfman says.
Among the tests that the investigators considered, CT scans are the most important from the standpoint of radiation exposure. Nearly 8% of the children in this study received a CT scan in the 3-year study period, with 3.5% of the children receiving more than one. Understanding patterns of utilization of these tests in children is important because children and infants are more susceptible than adults to the risks of radiation exposure, such as future cancers.
"Developing tissues in children are more sensitive to radiation and their longer expected life spans also allows additional time for the emergence of detrimental effects," says co-author, Reza Fazel, M.D., M.Sc., a cardiologist at the Emory School of Medicine. Fazel cautions that for any individual child undergoing a single test the risk is typically low.
"Of course, there is immense life-saving value in medical imaging, so our study doesn't suggest at all that these tests shouldn't be used in children," adds co-author Kimberly E. Applegate, M.D., vice chair for Quality and Safety in the Department of Radiology at Emory University. "We have to be smarter about how
|Contact: Margarita B. Wagerson|
University of Michigan Health System