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In medicine, more tests are not always better

Computed tomography, or CT scans, can aid in the diagnosis of various types of head trauma, such as traumatic brain injury. A CT scan goes beyond a traditional X-ray by providing images of bones, muscles, fat, organs and even whether blood vessels might be blocked. That additional information may improve doctors’ ability to diagnose traumatic brain injury -- even when a patient’s outward appearance seems normal.

Yet a CT scan is still a type of X-ray device, which means that it delivers a fair amount of radiation. Could that exposure be unsafe? For certain demographics, the answer might be yes.

According to a group of pediatric medical professionals, radiation exposure carries of risk of inducing malignancies in children. For that reason, CT scans should be ordered only when necessary, and not simply as a routine test. Although such imaging scans may serve an important purpose in pediatric patients with overt TBI symptoms, the risk-benefit analysis may be more nuanced in patients displaying only minor TBI symptoms.

Accordingly, the professionals recently developed a set of clinical rules to help doctors evaluate whether a young patient’s TBI symptoms might warrant a CT scan. Based on an analysis of nearly 15,000 CT scans, they were able to measure the accuracy of their prediction rules. 

Although undiagnosed TBI may pose a serious health risk, an attorney that focuses on medical malpractice claims knows that diagnostic testing should not make a patient worse or cause new injuries. Although there may be situations where the benefit outweighs the potential risk of an adverse reaction, that decision should be made jointly by a health care professional and his or her patient. Failing to educate a patient about such risks could also amount to medical malpractice.  

Source: Contemporary pediatrics, "Prediction rules help in evaluating head injuries," Karen Rosenberg, Oct. 14, 2014

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