{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T05:51:39Z","timestamp":1794289899361,"version":"4.9.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T00:00:00Z","timestamp":1571875200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"crossref","award":["1F32DE027604-01"],"award-info":[{"award-number":["1F32DE027604-01"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Routine postoperative computed tomography (CT) imaging in nonsyndromic craniosynostosis remains controversial due to the hazards of radiation exposure. The extent to which postoperative head CTs are performed remains unknown. Therefore, we sought to measure the use of postoperative CTs in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>The authors reviewed insurance claims from OptumInsight, using Current Procedural Terminology codes to identify procedures and postoperative imaging. Multilevel logistic regression was used to describe the odds of undergoing postoperative CTs, adjusting for patient and provider covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Craniosynostosis patients who underwent reconstruction between 2001 and 2017 were reviewed. Patients older than 5 years at surgery, postoperative lengths of stay &gt;15 days, syndromic diagnoses, operative complications within 30 days of surgery, and cranial bone grafting merited exclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure:<\/jats:title>\n                    <jats:p>Odds of postoperative head CTs after cranial vault reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In this cohort (n = 1150), 326 (28.4%) patients underwent postoperative head CTs. The number of CTs ranged from 0 to 14. Older age at surgery (odds ratio [OR]: 1.32,\n                      <jats:italic>P<\/jats:italic>\n                      = .002), increasing years of follow-up (OR: 1.12,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and increasing comorbidities (OR: 1.21,\n                      <jats:italic>P<\/jats:italic>\n                      = .017) were associated with postoperative CTs. After adjusting for patient factors, provider factors accounted for 31.3% of variation in imaging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Over a quarter of patients underwent head CTs following reconstruction, and provider factors accounted for a large percentage of the variation. Given the risks of radiation, neurosurgeons and craniofacial surgeons face a critical need to establish postoperative imaging protocols to reduce unnecessary imaging in these vulnerable patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665619882568","type":"journal-article","created":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T00:20:37Z","timestamp":1571962837000},"page":"288-295","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Variation in the Utilization of Postoperative Computed Tomography for Patients With Nonsyndromic Craniosynostosis: A National Claims Analysis"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7154-5241","authenticated-orcid":false,"given":"Katelyn G.","family":"Makar","sequence":"first","affiliation":[{"name":"Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidhya","family":"Gunaseelan","sequence":"additional","affiliation":[{"name":"Michigan Opioid Prescribing Engagement Network, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Waljee","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2015-4213","authenticated-orcid":false,"given":"Christian J.","family":"Vercler","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Buchman","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,10,24]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001300"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2018.05.008"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196606162742405"},{"issue":"6","key":"e_1_3_2_5_1","first-page":"8843e","article-title":"Persistent opioid use and high-risk prescribing in body contouring patients","volume":"142","author":"Bennett KG","year":"2018","unstructured":"Bennett KG, Kelley BP, Vick AD, Lee JS, Gunaseelan V, Brummett CM, Waljee JF. Persistent opioid use and high-risk prescribing in body contouring patients. Plast Reconstr Surg. 2018;142(6):8843e\u20138891e.","journal-title":"Plast Reconstr Surg"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001381"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.176.2.1760289"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra072149"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.1.PEDS15593"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S100248"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.113854"},{"issue":"8","key":"e_1_3_2_12_1","first-page":"584","article-title":"Excess lifetime cancer mortality risk attributable to radiation exposure from computed tomography examinations in children","volume":"9","author":"Chodick G","year":"2007","unstructured":"Chodick G, Ronckers CM, Shalev V, Ron E. Excess lifetime cancer mortality risk attributable to radiation exposure from computed tomography examinations in children. Isr Med Assoc J. 2007;9(8):584\u2013587.","journal-title":"Isr Med Assoc J"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001238"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000093"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.S1.205"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489175"},{"key":"e_1_3_2_17_1","volume-title":"Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation and National Research Council","author":"Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2","year":"2006","unstructured":"Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation and National Research Council. Washington, DC; The National Academies Press; 2006."},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2017.07.004"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004877"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003316"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-018-3746-5"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2017.02.042"},{"issue":"2","key":"e_1_3_2_23_1","first-page":"64","article-title":"Oral midazolam-ketamine versus midazolam alone for procedural sedation of children undergoing computed tomography: a randomized clinical trial","volume":"3","author":"Majidinejad S","year":"2015","unstructured":"Majidinejad S, Taherian K, Esmailian M, Khazaei M, Samaie V. Oral midazolam-ketamine versus midazolam alone for procedural sedation of children undergoing computed tomography: a randomized clinical trial. Emerg (Tehran). 2015;3(2):64\u201369.","journal-title":"Emerg (Tehran)"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(03)00179-X"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665617739000"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.43"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.1597\/11-138"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy104"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.311"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5063"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004052"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2011.04.005"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000305929.40363.bf"},{"key":"e_1_3_2_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004026"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53486-6.00064-8"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2014.03.004"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2018.09.039"},{"key":"e_1_3_2_38_1","first-page":"149","article-title":"Craniometric analysis of endoscopic suturectomy for bilateral coronal craniosynostosis","volume":"35","author":"Rothenberg PE","year":"2018","unstructured":"Rothenberg PE, Hughes BD, Amirkhosravi F, Onaiwu BP, Okereke IC. Craniometric analysis of endoscopic suturectomy for bilateral coronal craniosynostosis. Plast Reconstr Surg. 2018;35:149\u2013152.","journal-title":"Plast Reconstr Surg"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12922"},{"key":"e_1_3_2_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.5449"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004787"},{"key":"e_1_3_2_42_1","doi-asserted-by":"publisher","DOI":"10.14791\/btrt.2018.6.e4"},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2014-0090"},{"key":"e_1_3_2_44_1","unstructured":"Standards of Approval for Team Care. Available at: https:\/\/acpa-cpf.org\/team-care\/standardscat\/standards-of-approval-for%20team-care\/. Published February 2019 Accessed October 9 2019."},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000829"},{"key":"e_1_3_2_46_1","unstructured":"Out-of-Pocket Cost for Uninsured Patients. Available at: https:\/\/www.uofmhealth.org\/patient-visitor-guide\/uninsured-patients-pricing. Published August 1 2019. Accessed October 9 2019."},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318213be52"},{"key":"e_1_3_2_48_1","doi-asserted-by":"publisher","DOI":"10.1353\/nib.2015.0010"},{"key":"e_1_3_2_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2016.06.008"},{"key":"e_1_3_2_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182412a50"},{"key":"e_1_3_2_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12937"},{"key":"e_1_3_2_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-018-3721-1"},{"key":"e_1_3_2_53_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.9.PEDS14207"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665619882568","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1055665619882568","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665619882568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:20:15Z","timestamp":1777393215000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1055665619882568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,24]]},"references-count":52,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1177\/1055665619882568"],"URL":"https:\/\/doi.org\/10.1177\/1055665619882568","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,24]]}}}