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{
    "pk": 13640,
    "title": "Intracranial Traumatic Hematoma Detection in Children Using a Portable Near-infrared Spectroscopy Device",
    "subtitle": null,
    "abstract": "Introduction:\n We sought to validate a handheld, near-infrared spectroscopy (NIRS) device for detecting intracranial hematomas in children with head injury.\nMethods:\n Eligible patients were those <18 years old who were admitted to the emergency department at three academic children’s hospitals with head trauma and who received a clinically indicated head computed tomography (HCT). Measurements were obtained by a blinded operator in bilateral frontal, temporal, parietal, and occipital regions. Qualifying hematomas were a priori determined to be within the brain scanner’s detection limits of >3.5 milliliters in volume and <2.5 centimeters from the surface of the brain. The device’s measurements were positive if the difference in optical density between hemispheres was >0.2 on three successive scans. We calculated diagnostic performance measures with corresponding exact two-sided 95% Clopper-Pearson confidence intervals (CI). Hypothesis test evaluated whether predictive performance exceeded chance agreement (predictive Youden’s index > 0).\nResults:\n A total of 464 patients were enrolled and 344 met inclusion for primary data analysis: 10.5% (36/344) had evidence of a hematoma on HCT, and 4.7% (16/344) had qualifying hematomas. The handheld brain scanner demonstrated a sensitivity of 58.3% (21/36) and specificity of 67.9% (209/308) for hematomas of any size. For qualifying hematomas the scanner was designed to detect, sensitivity was 81% (13/16) and specificity was 67.4% (221/328). Predictive performance exceeded chance agreement with a predictive Youden’s index of 0.11 (95% CI, 0.10 – 0.15; P < 0.001) for all hematomas, and 0.09 (95% CI, 0.08 – 0.12; P < 0.001) for qualifying hematomas.\nConclusion:\n The handheld brain scanner can non-invasively detect a subset of intracranial hematomas in children and may serve an adjunctive role to head-injury neuroimaging decision rules that predict the risk of clinically significant intracranial pathology after head trauma.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "intracranial hematoma"
        },
        {
            "word": "brain injury"
        },
        {
            "word": "Head injury"
        },
        {
            "word": "spectroscopy"
        }
    ],
    "section": "Pediatrics",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/15d0z8w8",
    "frozenauthors": [
        {
            "first_name": "Matthew",
            "middle_name": "P.",
            "last_name": "Kirschen",
            "name_suffix": "",
            "institution": "Children’s Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Philadelphia, Pennsylvania\nChildren’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania\nChildren’s Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Sage",
            "middle_name": "R.",
            "last_name": "Myers",
            "name_suffix": "",
            "institution": "Children’s Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pennsylvania\nChildren’s Hospital of Philadelphia, Division of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Mark",
            "middle_name": "I.",
            "last_name": "Neuman",
            "name_suffix": "",
            "institution": "Boston Children’s Hospital, Division of Emergency Medicine, Department of Pediatrics, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Joseph",
            "middle_name": "A.",
            "last_name": "Grubenhoff",
            "name_suffix": "",
            "institution": "University of Colorado, Department of Pediatrics, Aurora, Colorado",
            "department": "None"
        },
        {
            "first_name": "Rebekah",
            "middle_name": "",
            "last_name": "Mannix",
            "name_suffix": "",
            "institution": "Boston Children’s Hospital, Division of Emergency Medicine, Department of Pediatrics, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Nicholas",
            "middle_name": "",
            "last_name": "Stence",
            "name_suffix": "",
            "institution": "Children’s Hospital Colorado, Department of Radiology, Aurora, Colorado",
            "department": "None"
        },
        {
            "first_name": "Edward",
            "middle_name": "",
            "last_name": "Yang",
            "name_suffix": "",
            "institution": "Boston Children’s Hospital, Department of Radiology, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Ashley",
            "middle_name": "L.",
            "last_name": "Woodford",
            "name_suffix": "",
            "institution": "Cooper Medical School of Rowan University, Camden, New Jersey",
            "department": "None"
        },
        {
            "first_name": "Tyson",
            "middle_name": "",
            "last_name": "Rogers",
            "name_suffix": "",
            "institution": "North American Science Associates Inc., Minneapolis, Minnesota",
            "department": "None"
        },
        {
            "first_name": "Anna",
            "middle_name": "",
            "last_name": "Nordell",
            "name_suffix": "",
            "institution": "North American Science Associates Inc., Minneapolis, Minnesota",
            "department": "None"
        },
        {
            "first_name": "Arastoo",
            "middle_name": "",
            "last_name": "Vossough",
            "name_suffix": "",
            "institution": "Children’s Hospital of Philadelphia, Department of Radiology, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Mark",
            "middle_name": "R.",
            "last_name": "Zonfrillo",
            "name_suffix": "",
            "institution": "Alpert Medical School of Brown University, Departments of Emergency Medicine and Pediatrics, Providence, Rhode Island",
            "department": "None"
        }
    ],
    "date_submitted": "2020-03-06T21:05:55+05:30",
    "date_accepted": "2020-03-06T21:05:55+05:30",
    "date_published": "2021-03-24T22:39:38+05:30",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13640/galley/7123/download/"
        }
    ]
}