{"id":"https://openalex.org/W7223663210","doi":"https://doi.org/10.5811/westjem.64410","title":"English versus Non-English Language Preference and Computed Tomography Use in Pediatric Minor Head Trauma","display_name":"English versus Non-English Language Preference and Computed Tomography Use in Pediatric Minor Head Trauma","publication_year":2026,"publication_date":"2026-10-27","ids":{"openalex":"https://openalex.org/W7223663210","doi":"https://doi.org/10.5811/westjem.64410"},"language":"en","primary_location":{"id":"doi:10.5811/westjem.64410","doi":"https://doi.org/10.5811/westjem.64410","is_oa":true,"landing_page_url":"https://doi.org/10.5811/westjem.64410","pdf_url":null,"source":{"id":"https://openalex.org/S2738799989","display_name":"Western Journal of Emergency Medicine","issn_l":"1936-900X","issn":["1936-900X","1936-9018"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","medline","poland-70","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320339","host_organization_name":"eScholarship Publishing, University of California","host_organization_lineage":["https://openalex.org/P4310320339"],"host_organization_lineage_names":["eScholarship Publishing, University of California"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Western Journal of Emergency Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.5811/westjem.64410","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5002100459","display_name":"David R. Nelson","orcid":"https://orcid.org/0000-0002-6541-6643","observed_orcids":["https://orcid.org/0000-0002-6541-6643","https://orcid.org/0000-0002-1086-0798","https://orcid.org/0000-0002-3240-0725"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"David R. Nelson","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0002-3240-0725","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5067432148","display_name":"Zachary T. Sheff","orcid":"https://orcid.org/0000-0002-1126-5712","observed_orcids":["https://orcid.org/0000-0002-1126-5712"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Zachary T. Sheff","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0002-1126-5712","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5074594107","display_name":"Alexander J. Kinstedt","orcid":"https://orcid.org/0000-0003-1346-5336","observed_orcids":["https://orcid.org/0000-0003-1346-5336"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Alexander J. Kinstedt","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0003-1346-5336","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111450013","display_name":"J. R. BARKER","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jennifer R. Barker","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5152994018","display_name":"Courtney Anne Kelly","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Courtney A. Kelly","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":500,"currency":"USD","value_usd":500},"apc_paid":{"value":500,"currency":"USD","value_usd":500},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.83342664,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"27","issue":"6","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10416","display_name":"Traumatic Brain Injury Research","score":0.8901000022888184,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10416","display_name":"Traumatic Brain Injury Research","score":0.8901000022888184,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12151","display_name":"Interpreting and Communication in Healthcare","score":0.022099999710917473,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10706","display_name":"Traumatic Brain Injury and Neurovascular Disturbances","score":0.019899999722838402,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/computed-tomography-use","display_name":"computed tomography use","score":0.8090000152587891},{"id":"https://openalex.org/keywords/language-preference","display_name":"language preference","score":0.9610000252723694},{"id":"https://openalex.org/keywords/non-english-speakers","display_name":"non-English speakers","score":0.8679999709129333},{"id":"https://openalex.org/keywords/traumatic-brain-injury","display_name":"traumatic brain injury","score":0.7940000295639038},{"id":"https://openalex.org/keywords/care-pathways","display_name":"care pathways","score":0.5619999766349792},{"id":"https://openalex.org/keywords/headache","display_name":"headache","score":0.8429999947547913},{"id":"https://openalex.org/keywords/racial-disparities","display_name":"racial disparities","score":0.6299999952316284},{"id":"https://openalex.org/keywords/health-disparities","display_name":"health disparities","score":0.47200000286102295},{"id":"https://openalex.org/keywords/short-term-clinical-outcomes","display_name":"short-term clinical outcomes","score":0.8009999990463257},{"id":"https://openalex.org/keywords/children-with-disabilities","display_name":"children with disabilities","score":0.37299999594688416},{"id":"https://openalex.org/keywords/children-with-autism-spectrum-disorder","display_name":"children with autism spectrum disorder","score":0.39399999380111694},{"id":"https://openalex.org/keywords/children-with-down-syndrome","display_name":"children with Down syndrome","score":0.5609999895095825},{"id":"https://openalex.org/keywords/children-with-intellectual-disabilities","display_name":"children with intellectual disabilities","score":0.5429999828338623},{"id":"https://openalex.org/keywords/children-with-developmental-disabilities","display_name":"children with developmental disabilities","score":0.3319999873638153}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9376000165939331},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.6008999943733215},{"id":"https://openalex.org/C3019520628","wikidata":"https://www.wikidata.org/wiki/Q2920572","display_name":"Head trauma","level":2,"score":0.5569999814033508},{"id":"https://openalex.org/C544519230","wikidata":"https://www.wikidata.org/wiki/Q32566","display_name":"Computed tomography","level":2,"score":0.5322999954223633},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.5012999773025513},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.4846000075340271},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.48410001397132874},{"id":"https://openalex.org/C2777975874","wikidata":"https://www.wikidata.org/wiki/Q2920572","display_name":"Head injury","level":2,"score":0.4171000123023987},{"id":"https://openalex.org/C2781017439","wikidata":"https://www.wikidata.org/wiki/Q1995526","display_name":"Traumatic brain injury","level":2,"score":0.40849998593330383},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.3950999975204468},{"id":"https://openalex.org/C3017944768","wikidata":"https://www.wikidata.org/wiki/Q1450463","display_name":"Poison control","level":2,"score":0.3693000078201294},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.36910000443458557},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.3646000027656555},{"id":"https://openalex.org/C143095724","wikidata":"https://www.wikidata.org/wiki/Q515895","display_name":"Odds","level":3,"score":0.3578999936580658},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.34599998593330383},{"id":"https://openalex.org/C2779760435","wikidata":"https://www.wikidata.org/wiki/Q5396169","display_name":"Minor (academic)","level":2,"score":0.3237000107765198},{"id":"https://openalex.org/C187960798","wikidata":"https://www.wikidata.org/wiki/Q7631152","display_name":"Subgroup analysis","level":3,"score":0.32089999318122864},{"id":"https://openalex.org/C2781249084","wikidata":"https://www.wikidata.org/wiki/Q908656","display_name":"Preference","level":2,"score":0.30630001425743103},{"id":"https://openalex.org/C2776567890","wikidata":"https://www.wikidata.org/wiki/Q306826","display_name":"Abbreviated Injury Scale","level":5,"score":0.29330000281333923},{"id":"https://openalex.org/C190385971","wikidata":"https://www.wikidata.org/wiki/Q373494","display_name":"Injury prevention","level":3,"score":0.28380000591278076},{"id":"https://openalex.org/C30036603","wikidata":"https://www.wikidata.org/wiki/Q17125150","display_name":"Severity of illness","level":2,"score":0.28060001134872437},{"id":"https://openalex.org/C85004164","wikidata":"https://www.wikidata.org/wiki/Q1089964","display_name":"Injury Severity Score","level":4,"score":0.2720000147819519},{"id":"https://openalex.org/C117568660","wikidata":"https://www.wikidata.org/wiki/Q1650843","display_name":"Multinomial logistic regression","level":2,"score":0.2720000147819519},{"id":"https://openalex.org/C97834683","wikidata":"https://www.wikidata.org/wiki/Q942508","display_name":"Thorax (insect anatomy)","level":2,"score":0.26249998807907104},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2606000006198883},{"id":"https://openalex.org/C2779818104","wikidata":"https://www.wikidata.org/wiki/Q5135341","display_name":"Closed head injury","level":3,"score":0.2581000030040741},{"id":"https://openalex.org/C17624336","wikidata":"https://www.wikidata.org/wiki/Q461644","display_name":"Glasgow Coma Scale","level":2,"score":0.2547999918460846},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.25429999828338623}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.5811/westjem.64410","doi":"https://doi.org/10.5811/westjem.64410","is_oa":true,"landing_page_url":"https://doi.org/10.5811/westjem.64410","pdf_url":null,"source":{"id":"https://openalex.org/S2738799989","display_name":"Western Journal of Emergency Medicine","issn_l":"1936-900X","issn":["1936-900X","1936-9018"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","medline","poland-70","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320339","host_organization_name":"eScholarship Publishing, University of California","host_organization_lineage":["https://openalex.org/P4310320339"],"host_organization_lineage_names":["eScholarship Publishing, University of California"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Western Journal of Emergency Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.5811/westjem.64410","doi":"https://doi.org/10.5811/westjem.64410","is_oa":true,"landing_page_url":"https://doi.org/10.5811/westjem.64410","pdf_url":null,"source":{"id":"https://openalex.org/S2738799989","display_name":"Western Journal of Emergency Medicine","issn_l":"1936-900X","issn":["1936-900X","1936-9018"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","medline","poland-70","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320339","host_organization_name":"eScholarship Publishing, University of California","host_organization_lineage":["https://openalex.org/P4310320339"],"host_organization_lineage_names":["eScholarship Publishing, University of California"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Western Journal of Emergency Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2137587987","https://openalex.org/W2892340000","https://openalex.org/W7122525951","https://openalex.org/W4283395445","https://openalex.org/W4297484780","https://openalex.org/W2001032895","https://openalex.org/W3015385778","https://openalex.org/W7166530398","https://openalex.org/W2913443901","https://openalex.org/W2878502581"],"abstract_inverted_index":{"Introduction:":[0],"Whether":[1],"the":[2,177,195,212,224],"use":[3,38,233,265,315],"of":[4,22,68,192,316],"computed":[5],"tomography":[6],"(CT)":[7],"in":[8,45,175,194,211,319],"pediatric":[9],"minor":[10,42,72],"head":[11,36,43,73,317],"trauma":[12,44],"varies":[13],"by":[14,299,338],"documented":[15],"language":[16,133,184,300,308,339],"preference":[17,185,275,309,340],"(English":[18],"vs":[19,145],"non-English),":[20],"independent":[21],"race,":[23],"is":[24,180],"not":[25,210,260,277,297,325,336],"well":[26],"understood.":[27],"Our":[28,92],"objective":[29],"was":[30,96,186,228,259,276,310,324],"to":[31,65,77],"identify":[32],"factors":[33],"associated":[34,187,230,262,278,312],"with":[35,41,71,188,231,244,263,279,313],"CT":[37,102,114,119,193,232,248,264,280,318],"among":[39,282,341],"children":[40],"an":[46],"institutional":[47],"Pediatric":[48],"Emergency":[49],"Care":[50],"Applied":[51],"Research":[52],"Network":[53],"(PECARN)-based":[54],"pathway.":[55],"Methods:":[56],"This":[57],"single-center":[58],"retrospective":[59],"cohort":[60,214],"study":[61],"included":[62],"patients":[63,284],"2":[64],"14":[66],"years":[67],"age":[69],"presenting":[70],"trauma,":[74],"January":[75],"2019":[76],"June":[78],"2022,":[79],"who":[80],"were":[81,118,170],"classified":[82,171],"as":[83],"low,":[84],"intermediate,":[85],"or":[86,113],"high":[87],"risk":[88],"using":[89],"PECARN":[90,320],"criteria.":[91],"primary":[93],"outcome":[94],"measure":[95],"a":[97],"three-level":[98],"clinical":[99,109,123,158,245,329],"pathway:":[100],"no":[101,104],"and":[103,121,132,142,163,242,293,332],"traumatic":[105],"brain":[106],"injury":[107],"(TBI);":[108],"TBI":[110,159,246],"without":[111,161,247],"CT;":[112],"performed.":[115],"Secondary":[116],"outcomes":[117,295,334],"positivity":[120,281],"short-term":[122,294,333],"outcomes.":[124],"Multinomial":[125],"logistic":[126],"regression":[127],"assessed":[128],"associations":[129],"between":[130],"pathway":[131],"preference,":[134],"age,":[135],"headache,":[136],"weighted":[137],"observed":[138],"symptom":[139],"score":[140],"(OSS),":[141],"race":[143,258,323],"(White":[144],"non-White).":[146],"Results:":[147],"Among":[148],"1,167":[149],"patients,":[150],"319":[151],"(27.3%)":[152],"underwent":[153],"CT,":[154,162],"132":[155],"(11.3%)":[156],"had":[157,166],"diagnosis":[160],"716":[164],"(61.4%)":[165],"neither;":[167],"430":[168],"(36.8%)":[169],"intermediate":[172],"risk\u2014the":[173],"subgroup":[174,197],"which":[176],"imaging":[178,345],"decision":[179],"most":[181],"discretionary.":[182],"Non-English":[183],"lower":[189,314],"adjusted":[190],"odds":[191,199],"intermediate-risk":[196,225,321],"(adjusted":[198],"ratio":[200],"[aOR],":[201],"0.48;":[202],"95%":[203,217,236,251,268,287],"CI,":[204,218,237,252,269,288],"0.24-0.92;":[205],"P":[206,220,239,254,271,290,302],"=":[207,221,255,272,291],".03)":[208],"but":[209],"full":[213],"(aOR,":[215,234,249,266,285],"0.78;":[216],"0.50-1.22;":[219],".27).":[222],"Within":[223],"subgroup,":[226],"OSS":[227],"strongly":[229],"3.65;":[235],"2.67-5.00;":[238],"<":[240],".001)":[241],"headache":[243],"4.94;":[250],"1.64-14.90;":[253],".005),":[256],"whereas":[257],"independently":[261,311],"1.36;":[267],"0.82-2.25;":[270],".48).":[273],"Language":[274],"scanned":[283],"1.10;":[286],"0.44-2.72;":[289],".84),":[292],"did":[296,335],"differ":[298,337],"(all":[301],">":[303],".35).":[304],"Conclusion:":[305],"Documented":[306],"non-English":[307],"children;":[322],"after":[326],"adjustment":[327],"for":[328],"severity.":[330],"Yield":[331],"imaged":[342],"patients;":[343],"however,":[344],"selection":[346],"precludes":[347],"conclusions":[348],"about":[349],"mechanism.":[350]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2026-10-27T00:00:00"}