PEDIATRICS Vol. 70 No. 4 October 1982, pp. 662-663
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Letter to the Editor

Stephen G. Pauker MD1, John C. Leonidas MD1, Anna Binkiewicz MD1, and R. Michael Scott MD1

1 New England Medical Center, Boston, MA 02111

We appreciate the thoughtful comments of Groner and Charney regarding the value of routine skull radiography in mild head trauma in children. They would be satisfied with less than perfect sensitivity in an algorithm designed to select children at high risk for fractures. If, as well may be the case, skull fractures are themselves poor predictors of clinical outcome, then one must raise an even more basic question—why try to detect skull fractures? Why use the presence of a fracture as a gold standard for performance?