{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:10:51Z","timestamp":1755216651634,"version":"3.43.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>Historically, oral contrast has been considered essential for the evaluation of abdominal pathology on computed tomography (CT). With advances in CT technology, the need for oral contrast has decreased. Many pediatric studies have shown that lack of oral contrast has no impact on the diagnostic accuracy of CT abdomen\/pelvis for evaluation of acute abdominal pain. This study evaluates the impact of updated oral contrast guidelines on patient throughput in a large multisite children\u2019s health care system.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This is a single pediatric health care system multisite retrospective study. Guidelines for abdominopelvic CT scans from pediatric emergency departments at 2 free-standing children\u2019s hospitals were modified to limit the use of oral contrast in 2021. Interrupted time series analysis was performed, evaluating the use of oral contrast before and after targeted intervention during 2019 and 2023, and the impact of guidelines on turnaround time for performance of CT examinations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 2259 abdominopelvic CT examinations from the emergency department (ED) were evaluated, 48.7% (1101\/2259) before intervention and 51.3% (1158\/2259) following intervention. Sex was similar during the 2 periods [females: 47.6% (524\/1101) and 48.9% (566\/1158) respectively; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.54]. Median (IQR) age was 10 years old (7 to 14) and 12 years old (7 to 15) in 2019 and 2023, respectively (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001). Before intervention, oral contrast was used in 32.7% (278\/851) examinations at hospital 1 and 41.6% (104\/250) examinations at hospital 2. Following intervention, oral contrast use decreased at hospital 1 to 5.4% (45\/835) and at hospital 2 to 2.5% (8\/323) (all <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). After intervention, mean time from CT order to examination completion at hospital 1 changed from 129 to 100 minutes (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) and at hospital 2 changed from 152 to 76 minutes(<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Changes to oral contrast guidelines successfully decreased the use of oral contrast in abdominopelvic CT scans from the pediatric ED, resulting in significantly improved examination throughput.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003418","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T07:00:08Z","timestamp":1748242808000},"page":"648-651","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Eliminating Oral Contrast on Computed Tomography Abdomen\/Pelvis Throughput in the Pediatric Emergency Setting"],"prefix":"10.1097","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3627-1916","authenticated-orcid":false,"given":"Farid","family":"Hajibonabi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashishkumar","family":"Parikh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Riedesel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetika","family":"Khanna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"R1-20250804","first-page":"83","article-title":"Managing acute abdominal pain in pediatric patients: current perspectives","volume":"8","author":"Hijaz","year":"2017","journal-title":"Pediatr Heal Med 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current role?","volume":"23","author":"Kielar","year":"2016","journal-title":"Emerg Radiol"},{"key":"R9-20250804","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1148\/radiol.2021211241","article-title":"U.S. Diagnostic Reference Levels and Achievable Doses for 10 Pediatric CT Examinations","volume":"302","author":"Kanal","year":"2022","journal-title":"Radiology"},{"key":"R10-20250804","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.2214\/AJR.09.2336","article-title":"Abdominal 64-MDCT for suspected appendicitis: the use of oral and IV contrast material versus IV contrast material only","volume":"193","author":"Anderson","year":"2009","journal-title":"Am J Roentgenol"},{"key":"R11-20250804","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.acra.2017.01.013","article-title":"CT for acute nontraumatic abdominal pain-is oral contrast really required?","volume":"24","author":"Kessner","year":"2017","journal-title":"Acad Radiol"},{"key":"R12-20250804","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s10140-006-0474-z","article-title":"Prospective comparison of helical CT of the abdomen and pelvis without and with oral contrast in assessing acute abdominal pain in adult emergency department patients","volume":"12","author":"Lee","year":"2006","journal-title":"Emerg Radiol"},{"key":"R13-20250804","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2214\/AJR.19.21989","article-title":"Positive oral contrast material for abdominal CT: current clinical indications and areas of controversy","volume":"215","author":"Pickhardt","year":"2020","journal-title":"AJR Am J Roentgenol"},{"key":"R14-20250804","doi-asserted-by":"crossref","first-page":"2956","DOI":"10.1007\/s00261-022-03574-6","article-title":"Positive oral contrast material for CT evaluation of non-traumatic abdominal pain in the ED: prospective assessment of diagnostic confidence and throughput metrics","volume":"47","author":"Triche","year":"2022","journal-title":"Abdom Radiol (New York)"},{"key":"R15-20250804","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s10140-016-1421-2","article-title":"Diagnosing acute appendicitis using a nonoral contrast CT protocol in patients with a BMI of less than 25","volume":"23","author":"Ramalingam","year":"2016","journal-title":"Emerg Radiol"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T16:00:13Z","timestamp":1754323213000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003418"}},"subtitle":["A Multisite Analysis"],"short-title":[],"issued":{"date-parts":[[2025,5,24]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003418","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"type":"print","value":"0749-5161"},{"type":"electronic","value":"1535-1815"}],"subject":[],"published":{"date-parts":[[2025,5,24]]},"assertion":[{"value":"2024-12-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}