{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:29:15Z","timestamp":1791203355978,"version":"4.2.0"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100001130","name":"Gerber Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Radiologic imaging is routinely performed to aid in diagnosis for hospitalized children. Identifying and reducing variability in imaging practices can improve care while reducing harms and costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To identify common inpatient pediatric conditions with high prevalence of imaging and variation in imaging practices and imaging\u2010related costs across hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional study of children 0\u201318 years old admitted to 50 children's hospitals in the Pediatric Health Information Systems database between 2017 and 2019. We excluded patients with complex chronic conditions, pregnancy, newborn, or neonatal intensive care charges, and those who died or who were discharged to hospice or rehabilitation facilities. Conditions with at least 2500 discharges and in which \u226530% of patients received imaging were included. Outcomes included imaging frequency, standardized imaging\u2010related costs (including all modalities across all encounters), and hospital\u2010level variation in imaging costs using the intraclass correlation coefficient (ICC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 56 included conditions, imaging was most frequently conducted in patients with pectus excavatum (97.8%), scoliosis (96.2%), and intestinal obstruction (96%). Fracture ($21.4 million), trauma ($15.7 million), and appendicitis ($8.6 million) had the highest total imaging\u2010related costs. Conditions with the highest geometric mean standardized imaging costs were nervous system disorders ($507), osteomyelitis ($494), vesicoureteral reflux\/hydronephrosis ($468). Scoliosis (ICC\u2009=\u20090.49) and preseptal cellulitis (ICC\u2009=\u20090.48) had the highest variation in imaging\u2010related costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To reduce imaging overuse in hospitalized children, conditions with frequent imaging, high imaging\u2010related costs, and high hospital\u2010level variation in imaging practices should serve as priorities for future evidence generation, guideline development, and\/or improvement initiatives.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.13562","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T23:24:36Z","timestamp":1733181876000},"page":"573-580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Identifying opportunities to reduce imaging overuse in hospitalized children"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4811-0617","authenticated-orcid":false,"given":"Sanyukta","family":"Desai","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine Dell Children's Medical Center Austin Texas USA"},{"name":"Department of Pediatrics Dell Medical School at the University of Texas in Austin Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Treasure","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Richardson","sequence":"additional","affiliation":[{"name":"Children's Hospital Association Lenexa Kansas 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