Improving ultrasound quality to reduce computed tomography use in pediatric appendicitis: The Safe and Sound campaign

Abstract

Background Safety concerns about the use of radiation-based imaging such as computed tomography (CT) in children have resulted in national recommendations to use ultrasound (US) for the diagnosis of appendicitis when possible. We evaluated the trends in CT and US use in a statewide sample and the accuracy of these modalities. Methods Patients less than or equal to 18 years undergoing appendectomy in Washington State from 2008 to 2013 were evaluated for preoperative US/CT use, as well as imaging/pathology concordance using data from the Surgical Care and Outcomes Assessment Program. Results Among 3,353 children, 98.3% underwent preoperative imaging. There was a significant increase in the use of US first over the study period (P