In Reply Prior to implementing new clinical interventions, study of their effect is necessary. Unintended consequences of overtesting occur, regardless of how benign the intervention appears. In our RCT, the FAST examination failed to improve any important clinical outcome compared with standard care. Therefore, routine use of the FAST examination in children is not supported by this study.
The baseline CT rate in our study was 54.6% (60% was the rate used in the sample size calculation). Although this is higher than CT rates in multicenter studies (45%1 and 43%2), the range in those studies was 4% to 96%.1,2 In one study, 25% of sites (including 2 free-standing children’s hospitals) had CT rates of more than 54.6%.2
Holmes JF, Kelley KM, Kuppermann N. The FAST Examination for Children With Abdominal Trauma—Reply. JAMA. 2017;318(14):1394–1395. doi:10.1001/jama.2017.12958