Abstract：
:Clinical decision support has been identified by the United States government as a method to decrease inappropriate imaging exams and promote judicious use of imaging resources. The adoption of this method will be incentivized by requiring appropriate use criteria to qualify for Medicare reimbursement starting in January 2020. While Medicare reimbursement is unlikely to directly impact pediatric imaging because of largely disparate patient populations, insurance providers typically use Medicare to benchmark their reimbursement guidelines. Therefore soon after their adoption these guidelines could become relevant to pediatric imaging. In this article we discuss how pediatric imaging was initially underrepresented in the clinical decision support realm, and how this was addressed by a subcommittee involving both American College of Radiology and Society for Pediatric Radiology members. We also present the experience of implementing clinical decision support software at two standalone pediatric hospitals and summarize the lessons learned from these deployments.
journal_name
Pediatr Radioljournal_title
Pediatric radiologyauthors
Chan SS,Francavilla ML,Iyer RS,Rigsby CK,Hernanz-Schulman Mdoi
10.1007/s00247-018-4322-6subject
Has Abstractpub_date
2019-04-01 00:00:00pages
486-492issue
4eissn
0301-0449issn
1432-1998pii
10.1007/s00247-018-4322-6journal_volume
49pub_type
杂志文章,评审abstract：:We report a case of hairy polyp of the pharynx diagnosed on brain MRI in order to stress the need to examine carefully all tissues included on an imaging study, even those outside the clinically stated region of interest, and to remind practitioners to consider unusual as well as common etiologies for neonatal respira...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-005-1500-0
更新日期：2005-11-01 00:00:00
abstract：:With improvements in survival among individuals diagnosed and treated for cancer there is an increasing recognition of the risk of long-term adverse effects of therapy. Second neoplasms represent one of the more serious late effects of treatment and are associated with a substantial level of morbidity and mortality. S...
journal_title：Pediatric radiology
pub_type： 杂志文章,评审
doi：10.1007/s00247-008-1066-8
更新日期：2009-02-01 00:00:00
abstract：BACKGROUND:The onset of Crohn disease (CD) can occur in childhood. Imaging, which often involves radiation, is frequent in CD both for disease diagnosis and follow-up. However, information regarding radiation dose for contemporary CT and fluoroscopy is not available for determining the cost/benefit ratio for imaging st...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-007-0702-z
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND:In the setting of clinically suspected Legg-Calvé-Perthes (LCP) disease and negative/equivocal radiographs, contrast-enhanced MRI can be performed to confirm the diagnosis. OBJECTIVE:To determine the frequency of unexpected causes of hip pain as identified by MRI in children with clinically suspected LCP di...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-010-1841-1
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVE:To examine the extent to which intracranial pressure (ICP) in children after severe brain trauma can be determined by cranial CT. MATERIALS AND METHODS:Two experienced paediatric radiologists, without any knowledge of the clinical symptoms, evaluated 124 CT scans from 65 children (average age 5.4 years) who ...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s002470000255
更新日期：2000-07-01 00:00:00
abstract：:The objective of this study was to compare the quality of conventional and helical computed tomography (CT) images in children unable to breath-hold. Sixteen patients (age range 1.1-7.5 years) underwent both conventional and helical chest CT on a General Electric HiSpeed Advantage scanner at a mean study interval of 3...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF02021699
更新日期：1995-01-01 00:00:00
abstract：:Deep venous thrombosis (DVT) is being increasingly recognized as a significant issue in children. Despite the low incidence of DVT, the risks of pulmonary embolism and death in children are significant. Post-thrombotic syndrome, a syndrome of chronic venous insufficiency, can have long-term adverse consequences in chi...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-013-2634-0
更新日期：2013-08-01 00:00:00
abstract：:The case report is presented of a neonate with a unilateral multicystic dysplastic kidney. An intravenous pyelogram revealed septations throughout this kidney with late pooling of contrast media within the cystic structures. The pathological data stresses the presence of normal appearing glomeruli interspersed between...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF01000126
更新日期：1975-03-20 00:00:00
abstract：BACKGROUND:Sonography has been used to predict pneumatic reduction outcome in children with intussusception. OBJECTIVE:To assess the prognostic significance of fluid between the intussusceptum and intussuscepiens with respect to reduction outcome, lead point or necrosis. MATERIALS AND METHODS:Sonograms of children wi...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-010-1931-0
更新日期：2011-06-01 00:00:00
abstract：BACKGROUND:Ipsilateral deviation of the uterus (IDU) has been suggested to be specific for torsion. OBJECTIVE:To investigate the sensitivity and specificity of IDU in diagnosing torsion. MATERIALS AND METHODS:We retrospectively reviewed the pelvic US examinations in girls performed at Nationwide Children's Hospital i...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-009-1172-2
更新日期：2009-04-01 00:00:00
abstract：BACKGROUND:Fever without a focus is defined as a temperature of 38° C or higher as the single presenting symptom. After extensive investigation, a large percentage (12-67%) of cases remain undiagnosed. OBJECTIVE:To assess the diagnostic value of whole-body magnetic resonance imaging (WB-MRI) in children with fever wit...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-020-04889-6
更新日期：2021-01-29 00:00:00
abstract：:A case is presented in which chronic renal failure led to intense visceral calcification, mainly to the lungs and heart. The discovery of cardiac calcifications on plain chest radiographs is exceedingly rare in renal patients. Punctate calcific deposits with an almost homogeneous distribution throughout the cardiac mu...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF02386824
更新日期：1986-01-01 00:00:00
abstract：:A case is reported in whom there was a unilateral complete arrest of differentiation of the otocyst associated with an ipsilateral mild hemifacial hypoplasia and auricular abnormalities. The patient's tympanic membrane and VII nerve function were normal and a normal ossicular mass was identified on CT Scan. This case ...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF02467313
更新日期：1989-01-01 00:00:00
abstract：:Previous studies have suggested that CT examinations of the brain in children soon after near-drowning incidents are not helpful in predicting clinical outcome and are not necessary. The clinical and CT findings of 19 pediatric near-drowning victims were reviewed for correlation with clinical and neurologic outcome. A...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF02010911
更新日期：1993-01-01 00:00:00
abstract：:Vasoactive intestinal polypeptide (VIP) secreting neural crest tumours are an uncommon but important treatable cause of intractable childhood diarrhoea. The radiological appearances of two cases are presented with a review of radiological findings in childhood VIP secreting neural crest tumours. Twenty eight cases of ...
journal_title：Pediatric radiology
pub_type： 杂志文章,评审
doi：10.1007/BF02011377
更新日期：1990-01-01 00:00:00
abstract：BACKGROUND:Patient organ doses may be estimated from CTDI values. More accurate estimates may be obtained by measuring KERMA (Kinetic Energy Released in Matter) in anthropomorphic phantoms and referencing these values to free-in-air X-ray intensity. OBJECTIVE:To measure KERMA ratios (R(K)) in pediatric phantoms at CT....
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-011-2336-4
更新日期：2012-05-01 00:00:00
abstract：:Burkitt lymphoma presenting as a peritoneal and small thickening problem mimicking carcinomatosis is very rare. We present a previously healthy 7-year-old boy with a 1-week history of worsening abdominal distention, vomiting and melena. He demonstrated liver nodules, but no pathologic chest or abdominal adenopathy was...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-008-1063-y
更新日期：2009-03-01 00:00:00
abstract：:Endobronchial carcinoid is an extremely rare neoplasm in children. We report a case in which this entity was prospectively diagnosed by 3-D CT bronchography with volume rendering techniques. The ability to prospectively implicate an endobronchial neoplasm in a child may help to guide subsequent therapy and management....
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-004-1293-6
更新日期：2004-12-01 00:00:00
abstract：:Extensive vascular calcification in an 8-year-old girl with perinatally acquired AIDS is reported. Complicating factors included cardiomyopathy, chronic lung disease, disseminated Mycobacterium avium complex (MAC), and wasting syndrome with total nutrition dependence. Plain abdominal films and CT of the abdomen immedi...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF01395718
更新日期：1996-01-01 00:00:00
abstract：:This report describes a case of ectopic intra-thoracic kidney, in which there was delayed appearance of this condition after a documented prior normal chest film. ...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF02343442
更新日期：1984-01-01 00:00:00
abstract：:A case in which there was thallium-201 (201Tl) uptake in Langerhans cell histiocytosis (LCH) of the left femoral diaphysis is presented. The authors propose that 201Tl scintigraphy is potentially useful in the diagnosis and follow-up of patients with LCH. ...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF01383394
更新日期：1996-10-01 00:00:00
abstract：:Two cases of neonatal spontaneous rupture of the esophagus are described, one of which is associated with a duodenal stenosis. Seventeen cases have been reported. They present clinically with non-specific signs of respiratory insufficiency and radiologically by a right-sided hydropneumothorax. Esophageal opacification...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF02386871
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Intraspinal rib head dislocation is an important but under-recognized consequence of dystrophic scoliosis in patients with neurofibromatosis 1 (NF1). OBJECTIVE:To present clinical and imaging findings of intraspinal rib head dislocation in NF1. MATERIALS AND METHODS:We retrospectively reviewed clinical pre...
journal_title：Pediatric radiology
pub_type： 杂志文章,评审
doi：10.1007/s00247-010-1789-1
更新日期：2010-12-01 00:00:00
abstract：:In early life, patients with sickle cell disease (SCD) can have acute, life-threatening emergencies related to splenic hypofunction (overwhelming bacterial sepsis), as well as anemic crises from acute splenic sequestration because of sudden pooling of blood in the spleen. The landmark penicillin prophylaxis study in 1...
journal_title：Pediatric radiology
pub_type： 杂志文章,评审
doi：10.1007/s00247-008-1049-9
更新日期：2009-01-01 00:00:00
abstract：:This is the first clinical and angiographic description of congenital subclavian steal in a patient with left aortic arch, isolation of the right subclavian artery, and an aortic diverticulum. ...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF01092954
更新日期：1980-07-01 00:00:00
abstract：:Shaken baby syndrome/abusive head trauma is a leading cause of morbidity and mortality in infants. The presence of a diffuse subdural hematoma without evidence of accident is a key diagnostic clue. The hematoma is typically attributed to rupture of the cerebral bridging veins due to violent shaking, with or without im...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-014-3171-1
更新日期：2014-12-01 00:00:00
abstract：:One of the obstacles in discussing childhood tuberculosis (TB) is the lack of standard descriptive terminology to classify the diverse spectrum of disease. Accurate disease classification is important, because the correct identification of the specific disease entity has definite prognostic significance. Accurate clas...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-004-1238-0
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Recent reports have highlighted the lifetime risk of malignancy from using ionizing radiation in pediatric imaging. Computed tomography (CT), which uses ionizing radiation, is employed extensively for neonatal brain imaging of term infants. Magnetic resonance (MR) provides an alternative that does not use io...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-003-0933-6
更新日期：2003-07-01 00:00:00
abstract：:About one-half of patients with meconium ileus (MI) present with a complication such as volvulus, atresia, meconium peritonitis or giant cystic meconium peritonitis. The treatment of these complications requires surgery. However, the preoperative diagnosis of complicated MI is difficult. We describe two neonates with ...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/s00247-004-1294-5
更新日期：2004-12-01 00:00:00
abstract：:To evaluate cystourethrography in the era of fetal screening, we evaluated retrospectively the clinical and imaging findings of all children up to the age of 1 year who underwent a cystourethrogram in a 5-year period (1987-1992). There were 292 children, 64 neonates (< 1 month, 51 boys, 13 girls) and 228 infants (1 mo...
journal_title：Pediatric radiology
pub_type： 杂志文章
doi：10.1007/BF02015017
更新日期：1994-01-01 00:00:00
