{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:16:07Z","timestamp":1773303367136,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,1,10]],"date-time":"2013-01-10T00:00:00Z","timestamp":1357776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2013,4]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Head injury causes significant morbidity and mortality, and there is contention about which patients to scan. The UK N<\/jats:styled-content>ational H<\/jats:styled-content>ealth S<\/jats:styled-content>ervice C<\/jats:styled-content>linical G<\/jats:styled-content>uideline (CG) 56 provides criteria for selecting patients with clinically important brain injury who may benefit from a head CT<\/jats:styled-content> scan, while minimising the radiation and economic burden of scanning patients without significant injury. This study aims to audit the documentation of the use of these guidelines in a busy UK<\/jats:styled-content> trauma hospital and discusses the comparison with an A<\/jats:styled-content>ustralian (N<\/jats:styled-content>ew S<\/jats:styled-content>outh W<\/jats:styled-content>ales (NSW<\/jats:styled-content>) ) head injury guideline.<\/jats:p><\/jats:sec>Methods<\/jats:title>A retrospective cohort study of 480 patients presenting with head injury to the emergency department over 2 months was performed. The patient notes were assessed for documentation of each aspect of the clinical guidelines. Criteria were established to assess the utilisation of the CG<\/jats:styled-content> 56. A database of clinical data was amalgamated with the head CT<\/jats:styled-content> scan results for each patient.<\/jats:p><\/jats:sec>Results<\/jats:title>For the UK CG<\/jats:styled-content> 56, 73% of the criteria were documented, with the least documented being \u2018signs of basal skull fracture\u2019 and \u2018amnesia of events\u2019. Thirty\u2010two per cent of patients received head CT<\/jats:styled-content> and of these, 24% (37 patients) were reported to have pathology. Twenty\u2010four patients underwent head CT<\/jats:styled-content> without clinical justification being documented, none of which had reported pathology on CT<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The study shows that the head injury guidelines are not being fully utilised at a major UK<\/jats:styled-content> trauma hospital, resulting in 5% of patients being exposed to ionising radiation without apparent documented clinical justification. The NSW<\/jats:styled-content> guideline has distinct differences to the CG<\/jats:styled-content> 56, with a more complex algorithm and an absence of specific time frames for head CT<\/jats:styled-content> completion. The results suggest a need for further education and awareness of head injury clinical guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12007","type":"journal-article","created":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T04:14:42Z","timestamp":1357877682000},"page":"161-168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Head injury: Audit of a clinical guideline to justify head CT<\/scp>"],"prefix":"10.1111","volume":"57","author":[{"given":"Nicholas B","family":"Haydon","sequence":"first","affiliation":[{"name":"St Vincent's Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,1,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-5-21"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2005.081901"},{"key":"e_1_2_6_4_1","unstructured":"National Institute for Health and Clinical Excellence.Clinical Guideline 56; Head Injury: triage assessment investigation and early management of head injury in infants children and adults 2007."},{"key":"e_1_2_6_5_1","volume-title":"Grainger & Allison's Diagnostic Radiology","author":"Gillard J","year":"2008"},{"key":"e_1_2_6_6_1","unstructured":"New South Wales Department of Health.Diagnostic Imaging Pathways.2012. [Cited 3 Jul 2012.] Available from URL:http:\/\/www.health.nsw.gov.au\/policies\/pd\/2012\/pdf\/PD2012_013.pdf NSW Health website."},{"key":"e_1_2_6_7_1","unstructured":"Government of Western Australia Department of Health.Diagnostic Imaging Pathways.2007. [Cited 3 Jul 2012.] Available from URL:http:\/\/www.imagingpathways.health.wa.gov.au\/includes\/pdf\/headinj.pdf Department of Health Western Australia."},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.12.1511"},{"key":"e_1_2_6_9_1","volume-title":"Diagnostic Imaging","author":"Armstrong P","year":"2004"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000226154.38852.e6"},{"key":"e_1_2_6_11_1","volume-title":"Cambridge Medicine","author":"Christian Fox J","year":"2008"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra072149"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.75.889.750001"},{"key":"e_1_2_6_14_1","unstructured":"DarwentM.Clinical Lead\u2013 Accident & Emergency John Radcliffe Hospital Oxford UK November2010."}],"container-title":["Journal of Medical Imaging and Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1754-9485.12007","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.12007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T00:12:27Z","timestamp":1697328747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1754-9485.12007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,10]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,4]]}},"alternative-id":["10.1111\/1754-9485.12007"],"URL":"https:\/\/doi.org\/10.1111\/1754-9485.12007","archive":["Portico"],"relation":{},"ISSN":["1754-9477","1754-9485"],"issn-type":[{"value":"1754-9477","type":"print"},{"value":"1754-9485","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,10]]},"assertion":[{"value":"2012-04-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-08-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-01-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}