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BMJ 2006; 332 doi: (Published 16 March 2006) Cite this as: BMJ 2006;332:653
  1. Harvey Marcovitch, BMJ syndication editor (

    NICE's head injury guidelines aren't cost beneficial

    Guidelines introduced to the NHS in 2003 by the National Institute for Health and Clinical Excellence (NICE) for managing head injury have resulted in increasing use of computed tomography and a reduction in x rays of the skull but increases in radiation dosage and cost. Successive audits at Barnet Hospital, England, have shown a threefold increase in CT requests for computed tomography (75% out of hours) over the pre-existing local guidelines derived from the Royal College of Radiologists' recommendations. The admission rate was unchanged but reattendances increased, possibly because patients who weren't scanned didn't have the reassurance of a skull x ray. No patient with brain injury was missed in either audit period. The estimated extra cost to the hospital was £15 278 (€22 400; $26 600) per 100 head injuries. …

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