{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:59:55Z","timestamp":1790405995185,"version":"4.1.0"},"reference-count":26,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Emergency Medicine"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.ajem.2026.07.005","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T23:30:58Z","timestamp":1783380658000},"page":"148-154","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["A multimodal intervention reduces computed tomography use in blunt head injury"],"prefix":"10.1016","volume":"109","author":[{"given":"Yosef","family":"Berlyand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Smith Shain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Savarino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Shanin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared S.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.ajem.2026.07.005_bb0005","doi-asserted-by":"crossref","DOI":"10.1016\/j.annemergmed.2010.05.027","article-title":"Computed tomography use in the adult emergency department of an academic urban hospital from 2001 to 2007","volume":"56","author":"Lee","year":"2010","journal-title":"Ann Emerg Med"},{"issue":"5","key":"10.1016\/j.ajem.2026.07.005_bb0010","doi-asserted-by":"crossref","DOI":"10.1016\/j.annemergmed.2011.05.020","article-title":"National trends in use of computed tomography in the emergency department","volume":"58","author":"Kocher","year":"2011","journal-title":"Ann Emerg Med"},{"issue":"5","key":"10.1016\/j.ajem.2026.07.005_bb0015","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/j.1553-2712.2012.01353.x","article-title":"Effect of testing and treatment on emergency department length of stay using a national database","volume":"19","author":"Kocher","year":"2012","journal-title":"Acad Emerg Med"},{"issue":"22","key":"10.1016\/j.ajem.2026.07.005_bb0020","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1001\/archinternmed.2009.427","article-title":"Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer","volume":"169","author":"Smith-Bindman","year":"2009","journal-title":"Arch Intern Med"},{"issue":"22","key":"10.1016\/j.ajem.2026.07.005_bb0025","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1001\/archinternmed.2009.440","article-title":"Projected cancer risks from computed tomographic scans performed in the United States in 2007","volume":"169","author":"Berrington De Gonz\u00e1lez","year":"2009","journal-title":"Arch Intern Med"},{"issue":"1","key":"10.1016\/j.ajem.2026.07.005_bb0030","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1148\/radiol.10100640","article-title":"National trends in CT use in the emergency department: 1995-2007","volume":"258","author":"Larson","year":"2011","journal-title":"Radiology"},{"issue":"6","key":"10.1016\/j.ajem.2026.07.005_bb0035","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1111\/acem.12684","article-title":"Trends in advanced computed tomography use for injured patients in United States emergency departments: 2007\u20132010","volume":"22","author":"Hussein","year":"2015","journal-title":"Acad Emerg Med"},{"issue":"12","key":"10.1016\/j.ajem.2026.07.005_bb0040","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000214347","article-title":"Trends in head CT use in US emergency department patients from 2007 to 2022: a Nationwide analysis","volume":"105","author":"Dylla","year":"2025","journal-title":"Neurology"},{"issue":"9266","key":"10.1016\/j.ajem.2026.07.005_bb0045","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0140-6736(00)04561-X","article-title":"The Canadian CT head rule for patients with minor head injury","volume":"357","author":"Stiell","year":"2001","journal-title":"Lancet"},{"issue":"5","key":"10.1016\/j.ajem.2026.07.005_bb0050","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1067\/mem.2002.129245","article-title":"Developing a clinical decision instrument to rule out intracranial injuries in patients with minor head trauma: methodology of the NEXUS II investigation","volume":"40","author":"Mower","year":"2002","journal-title":"Ann Emerg Med"},{"issue":"12","key":"10.1016\/j.ajem.2026.07.005_bb0055","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1111\/acem.12821","article-title":"Choosing wisely in emergency medicine: a National Survey of emergency medicine academic chairs and division chiefs","volume":"22","author":"Maughan","year":"2015","journal-title":"Acad Emerg Med"},{"issue":"5","key":"10.1016\/j.ajem.2026.07.005_bb0060","doi-asserted-by":"crossref","first-page":"e63","DOI":"10.1016\/j.annemergmed.2023.01.014","volume":"81","author":"Valente","year":"2023","journal-title":"Ann Emerg Med"},{"issue":"8","key":"10.1016\/j.ajem.2026.07.005_bb0065","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.ajem.2018.05.018","article-title":"Utilization of head CT during injury visits to United States emergency departments: 2012\u20132015","volume":"36","author":"Yun","year":"2018","journal-title":"Am J Emerg Med"},{"issue":"2","key":"10.1016\/j.ajem.2026.07.005_bb0070","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s10140-020-01846-6","article-title":"Overuse of brain CT scan for evaluating mild head trauma in adults","volume":"28","author":"Shobeirian","year":"2021","journal-title":"Emerg Radiol"},{"issue":"5","key":"10.1016\/j.ajem.2026.07.005_bb0075","doi-asserted-by":"crossref","first-page":"821","DOI":"10.5811\/westjem.2017.6.33685","article-title":"Head CT for minor head injury presenting to the emergency department in the era of choosing wisely","volume":"18","author":"DeAngelis","year":"2017","journal-title":"West J Emerg Med"},{"issue":"5","key":"10.1016\/j.ajem.2026.07.005_bb0080","article-title":"Adherence to the Canadian CT head rule in a Nova Scotian emergency and trauma center","volume":"15","author":"Sampalli","year":"2023","journal-title":"Cureus"},{"issue":"11","key":"10.1016\/j.ajem.2026.07.005_bb0085","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1111\/j.1553-2712.2007.tb02372.x","article-title":"Implementation of clinical decision rules in the emergency department","volume":"14","author":"Stiell","year":"2007","journal-title":"Acad Emerg Med"},{"issue":"2","key":"10.1016\/j.ajem.2026.07.005_bb0090","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.annemergmed.2018.10.034","article-title":"Scope and influence of electronic health record\u2013integrated clinical decision support in the emergency department: a systematic review","volume":"74","author":"Patterson","year":"2019","journal-title":"Ann Emerg Med"},{"issue":"3","key":"10.1016\/j.ajem.2026.07.005_bb0095","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.ajem.2014.11.005","article-title":"Impact of clinical decision support on head computed tomography use in patients with mild traumatic brain injury in the ED","volume":"33","author":"Ip","year":"2015","journal-title":"Am J Emerg Med"},{"issue":"e2","key":"10.1016\/j.ajem.2026.07.005_bb0100","doi-asserted-by":"crossref","first-page":"e347","DOI":"10.1136\/amiajnl-2013-002536","article-title":"Effect of clinical decision support on documented guideline adherence for head CT in emergency department patients with mild traumatic brain injury","volume":"21","author":"Gupta","year":"2014","journal-title":"J Am Med Inform Assoc"},{"issue":"7","key":"10.1016\/j.ajem.2026.07.005_bb0105","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/acem.13195","article-title":"Embedded clinical decision support in electronic health record decreases use of high-cost imaging in the emergency department: EmbED study","volume":"24","author":"Bookman","year":"2017","journal-title":"Acad Emerg Med"},{"issue":"8","key":"10.1016\/j.ajem.2026.07.005_bb0110","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1097\/ACM.0000000000003098","article-title":"Making decisions in the era of the clinical decision rule: how emergency physicians use clinical decision rules","volume":"95","author":"Chan","year":"2020","journal-title":"Acad Med"},{"issue":"2","key":"10.1016\/j.ajem.2026.07.005_bb0115","doi-asserted-by":"crossref","DOI":"10.2196\/12469","article-title":"Interruptive versus noninterruptive clinical decision support: usability study","volume":"6","author":"Blecker","year":"2019","journal-title":"JMIR Hum Factors"},{"issue":"1","key":"10.1016\/j.ajem.2026.07.005_bb0120","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.annemergmed.2017.06.022","article-title":"Implementation of the Canadian CT head rule and its association with use of computed tomography among patients with head injury","volume":"71","author":"Sharp","year":"2018","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.ajem.2026.07.005_bb0125","series-title":"Understanding Variation: The Key to Managing Chaos","author":"Wheeler","year":"2000"},{"issue":"11","key":"10.1016\/j.ajem.2026.07.005_bb0130","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1136\/bmjqs-2024-018130","article-title":"RECi-PE (REducing CT in pulmonary embolism diagnosis): an emergency department quality intervention","volume":"34","author":"Anderson","year":"2025","journal-title":"BMJ Qual Saf"}],"container-title":["The American Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735675726003281?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735675726003281?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:35:51Z","timestamp":1790404551000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0735675726003281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":26,"alternative-id":["S0735675726003281"],"URL":"https:\/\/doi.org\/10.1016\/j.ajem.2026.07.005","relation":{},"ISSN":["0735-6757"],"issn-type":[{"value":"0735-6757","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A multimodal intervention reduces computed tomography use in blunt head injury","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Emergency Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajem.2026.07.005","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}