• clinical decision support
• abdominal pain
• pediatric
• imaging

BACKGROUND. The management of acute abdominal pain in pediatric patients is often discussed in particular with regard to imaging diagnostic procedure. Many objections have arisen in the past years with regard to the consequences of radiation exposure and its effect on children. In order to optimize and perform the appropriate imaging investigation Clinical Decision Supports such as the ESR iGuide were introduced.
TARGETS. The purpose of this study is to evaluate whether the application of the ESR iGuide CDS would have changed the diagnostic workflow followed in this clinical setting.
MATERIALS AND METHODS. Three hundred and fifty two pediatric patients were included in this retrospective study. These patients attended the Emergency Department of Pisa University Hospital between January 2011 and December 2016. All patients presented either with abdominal pain alone or abdominal pain associated with other signs or symptoms.
The clinical scenarios were introduced in the ESR iGuide CDS to compare performed against suggested examinations.
RESULTS. Globally the Cohen K was less than 0,2 (poor agreement). Except for US, other imaging modalities were strongly suggested by the ESR iGuide CDS but not performed, for example abdomen X-ray, abdomen CT with IV contrast and MRI
CONCLUSION. There were some contradictions between the CDS indication and the clinician’s decision. However, this study presents some limitations and it is possible that a different selection of patients, would have given different results.