dc.contributor.author	Daymont, Carrie
dc.contributor.author	McDonald, Patrick J
dc.contributor.author	Wittmeier, Kristy
dc.contributor.author	Reed, Martin H
dc.contributor.author	Moffatt, Michael
dc.date.accessioned	2014-07-02T19:03:07Z
dc.date.available	2014-07-02T19:03:07Z
dc.date.issued	2014-06-23
dc.date.updated	2014-07-02T19:03:07Z
dc.description.abstract	Abstract Background We sought to determine the extent to which physicians agree about the appropriate decision threshold for recommending magnetic resonance imaging in a clinical practice guideline for children with recurrent headache. Methods We surveyed attending physicians in Canada practicing in community pediatrics, child neurology, pediatric radiology, and pediatric neurosurgery. For children in each of six risk categories, physicians were asked to determine whether they would recommend for or against routine magnetic resonance imaging of the brain in a clinical practice guideline for children with recurrent headache. Results Completed surveys were returned by 114 physicians. The proportion recommending routine neuroimaging for each risk group was 100% (50% risk), 99% (10% risk), 93% (4% risk), 54% (1% risk), 25% (0.4% risk), 4% (0.01% risk). Community pediatricians, physicians in practice >15 years, and physicians who believed they ordered neuroimaging less often than peers were less likely to recommend neuroimaging for the 1% risk group (all p < 0.05). Conclusions There is no consensus among pediatric specialists regarding the appropriate decision threshold for neuroimaging in a clinical practice guideline for children with recurrent headache. Because of the impact that individual threshold preferences may have on guidelines, these findings support the need for careful composition of guideline committees and consideration of the role of patient and family preferences. Our findings also support the need for transparency in guidelines regarding how evidence was translated into recommendations and how conflicts were resolved.
dc.description.version	Peer Reviewed
dc.identifier.citation	BMC Pediatrics. 2014 Jun 23;14(1):162
dc.identifier.doi	http://dx.doi.org/10.1186/1471-2431-14-162
dc.identifier.uri	http://hdl.handle.net/1993/23676
dc.language.rfc3066	en
dc.rights	open access	en_US
dc.rights.holder	Carrie Daymont et al.; licensee BioMed Central Ltd.
dc.title	Variability of physicians¿ thresholds for neuroimaging in children with recurrent headache
dc.type	Journal Article

Variability of physicians¿ thresholds for neuroimaging in children with recurrent headache

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