TABLE 1

Criteria Used To Evaluate the Importance of Overuse Articles

CriterionDescriptionHigh-Scoring Examples
(1) Quality of methodsWere studies adequately powered and to what extent were selection bias and confounding mitigated?Silver et al16 randomized patients to an intervention and were powered to detect a difference in their primary outcome, length-of-stay, of 0.6 d.
(2) Magnitude of clinical effectHow substantial are the potential ramifications of overuse?Powell et al17 found that children diagnosed with skull fractures were unnecessarily hospitalized and exposed to repeated head CT scans.
(3) Number of Patients Potentially EffectedHow large is the population being exposed to overuse?Frequent HC screening is recommended for all US infants. Wright et al18 found that 18% of their cohort had at least 1 extreme measurement in the first 2 years of life.