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Table 2 Use of 20 Low Value Service Measures and Risk Ratios

From: Use of low-value pediatric services in the Military Health System

No. Servicea Denominator Definitiona No. of Children in Denominator No. Receiving Service at Least Once During FY % of Denom Receiving Service at Least Once During FY % of All Children (n = 1,111,543) Receiving Service at Least Once During FY No. of Services During FY No. of Services per 100 Children in Denominator
1 Population-based screening for vitamin D deficiency All children 1,111,534 10,242 0.92 0.92 10,753 0.97
2 Skin prick test or IgE blood tests in children with atopic dermatitis Children with a diagnosis of atopic dermatitis during the FY 27,659 340 1.23 0.03 356 1.29
3 Testing for RSV in children with bronchiolitis Children with diagnosis of bronchiolitis during FY 13,813 1096 7.93 0.10 1143 8.27
4 Blood tests in children with a simple febrile seizure Children with diagnosis of simple febrile seizure during FY 1987 129 6.49 0.01 137 6.89
5 Cervical cancer screening w/ HPV test or papanicolaou test in children Female children aged ≥14 years 139,425 1115 0.80 0.10 1137 0.82
6 Testing for group A streptococcal pharyngitis in children aged < 3 years Children aged < 3 years 177,669 19,467 10.96 1.75 24,979 14.06
7 Face or nose radiograph in children with head or face trauma Children with diagnosis of head or face trauma during FY 57,943 1013 1.75 0.09 1023 1.77
8 Ultrasound in children with cryptorchidism Children with diagnosis of cryptorchidism during FY 1823 348 19.09 0.03 354 19.42
9 Sinus imaging in children with acute sinusitis Children with diagnosis of acute sinusitis during FY 44,399 68 0.15 0.01 85 0.19
10 Neuroimaging in children with a simple febrile seizure Children with a diagnosis of simple febrile seizure during the FY 1987 39 1.96 0.00 39 1.96
11 Neuroimaging in children with headache Children aged ≥12 years with a diagnosis of headache during the FY 29,801 2807 9.42 0.25 3022 10.14
12 Cough and cold medications in children aged < 6 y Children aged < 6 years 363,376 108,574 29.88 9.77 136,381 37.53
13 Oral antibiotics for acute upper respiratory infections Children with a diagnosis of acute upper respiratory infection during the FY 224,222 28,156 12.56 2.53 29,440 13.13
14 Oral antibiotics for acute OME Children with a diagnosis of acute OME during the FY 26,313 10,553 40.11 0.95 10,872 41.32
15 Oral antibiotics for acute otitis externa Children with a diagnosis of acute otitis externa during the FY 22,399 2184 9.75 0.20 2249 10.04
16 Oral antibiotics after tonsillectomy Children undergoing tonsillectomy during the FY 6727 612 9.10 0.06 612 9.10
17 Oral antibiotics for bronchiolitis Children with a diagnosis of bronchiolitis during the FY 13,813 2245 16.25 0.20 2368 17.14
18 Oral corticosteroids for bronchiolitis Children with a diagnosis of bronchiolitis during the FY 13,813 2857 20.68 0.26 3222 23.33
19 Short-acting β-agonists for bronchiolitis Children with a diagnosis of bronchiolitis during the FY 13,813 5209 37.71 0.47 5634 40.79
20 Acid blockers for infants with uncomplicated gastroesophageal reflux Infants aged < 1 year 54,023 2395 4.43 0.22 5168 9.57
  1. aMeasures and denominator definitions as described by Chua, et al [11]