NEW YORK, Aug 19 (Reuters) - The number of U.S. children and adults getting computed tomography scans to diagnose appendicitis has shot up since the 1990s, according to a study -- raising questions about whether the technology is being over used.
In the study, carried in the Annals of Emergency Medicine, researchers found that across U.S. emergency departments, the percentage of adult appendicitis patients who were diagnosed using CT scans rose from just 6 percent in 1996 to 69 percent in 2006.
Among children, that figure went from zero to 60 percent, said researchers led by Daniel Tsze, a pediatrician at Columbian University Medical Center in New York.
Tsze said he could not say whether those recent numbers are "too high" because CT is the most accurate test for appendicitis, which is likely a major reason for the dramatic upswing in its use.
But there is also no evidence as yet that using CT improves patients' outcomes, he added. If it did, the downsides of radiation exposure and cost could be worth it.
"There are definitely situations where it's indicated, but I don't think it's indicated in every case," he told Reuters Health.
One reason for the CT surge in diagnosing children's appendicitis is that the technology has improved in recent years. A scan can now be done so quickly that even young children can hold still long enough, whereas in the past they would have had to be sedated.
Young children are also less able to talk about their symptoms, and in cases where there is confusion about the cause, a CT scan might be in order.
"A lot of people are pushing for a combination of strategies," Tsze said, noting that there is a move to encourage a more judicious use of CT scans in cases of suspected appendicitis.
An alternative to a CT scan is ultrasound, which involves no radiation -- though it is not as accurate.
Another study published this month found that for all types of emergency room visits, interviewing patients about symptoms and getting a good history usually contributed far more to a doctor's ability to make the right diagnosis than either CT or ultrasound scans.
In a separate finding, Tsze's team found that children with appendicitis were less likely than adults to get pain medication. In 2006, 70 percent of adults were given painkillers, versus only 43 percent of children.
In particular, children were less likely to get narcotic painkillers, perhaps due to worries about safety. But Tsze said studies have shown narcotics are safe and effective for children's appendicitis. (Reporting by Amy Norton at Reuters Health; editing by Elaine Lies)
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