Lead Investigator First Hansel
Name
Lead Investigator
J
Middle Initial
Lead Investigator Last Otero
Name
Lead Investigator
MD
Degree
Institution
Children's National Medical Center
Current Institution
Department of Diagnostic Imaging and Radiology
Department
Rank or Position
Assistant Professor of Pediatric and Radiology
Address
111 Michigan ave depart of radiology
Washington, DC 20010
United States
Phone Number
(202) 476-4252
Fax
(202) 476-3644
Training Dates
• Brigham & Women’s Hospital – Harvard Medical School Jul 2005-Jun 2006
Gill Management and Hospital Administration Fellowship
• Brigham & Women’s Hospital – Harvard Medical School Jul 2006- Jun 2007
Radiology Management Fellowship
• Hurley Medical Center, Michigan State University
Jul 2008- Jun 2009
Internship-Transitional year
• Tufts Medical Center, Tufts University Medical School
Jul 2009- Jun 2013
Diagnostic Radiology Residency
• Children’s Hospital of Philadelphia
Jul 2013- Jun 2014
Pediatric Radiology Fellowship
Email
hotero@childrensnational.org
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Is this application
No
based on an
application submitted
to this or any other
organization in the
past two years?
Co-
Lauren
Investigator/Mentor
First Name 1
Co-
A
Investigator/Applicant
Name MI 1
CoInvestigator/Applicant
Last Name 1
Crowder
Co-
BS, MPH, CPH
Investigator/Applicant
Degree 1
Co-
Children's National Medical Center
Investigator/Applicant
1 Institution
Co-
Co-investigator, public health/epidemiology expert
Investigator/Applicant
1 Project Role
Co-
LCrowder@childrensnational.org
Investigator/Applicant
Name Email 1
Project Title
Imaging Utilization in the Diagnosis of Appendicitis in Children in the United
States: Analysis of trends, costs and outcomes
Abstract of Proposed Research Plan (300 words)
Appendicitis the most common surgical emergency in children in this country. Imaging has shown to
decrease the rate of false positive cases without increasing complications. The recommendation for
imaging suspected appendicitis in children according to ACR appropriateness criteria favors initial
evaluation with ultrasound, with CT being useful after negative or equivocal ultrasound. Review of a large
database suggested a decreased use of CT up to 2009 at major pediatric institutions, in keeping with
acceptance of the benefits of initial investigation with US. However, a recent review of the same database
of major pediatric hospitals shows a 3.5 folds difference in utilization rates of ultrasound and CT.
Variation might be even higher in non-pediatric hospitals, which manage up to 80% of appendicitis cases
in the country. To date it is unclear if the variation is related to type of institution or type of patient (i.e.
demographics). Moreover, t hese findings might be used as a corollary for measuring impact of increased
public awareness about the potential harmful effects of ionizing radiation, driven in part by a national
education and communication campaign in radiology, Image Gently(SM), on clinical practice.
In the last few years, alternative imaging algorithms to limit the use of CT that include repeat ultrasounds
and the incorporation of MRI, have been proposed. The adoption and financial impact of these alternative
pathways are also unknown.
We propose to determine the trends and variation of imaging utilization practices in the US over the last
12 years and their relationship to demographic and outcomes. The cost fraction represented by imaging in
pediatric appendicitis expenses will also be established. If decrease CT and increased ultrasound and/or
MRI utilization can be achieved without increasing cost or negatively impacting outcomes, then a
recommendation to update the ACR guidelines can be made.
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and bibliography
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Resources and Environment:
The PI has prior relevant training including 2 years of dedicated research fellowships on radiology
administration and hospital management as well as over 15 publications in health services
topics16171819. Specifically, he has prior publications studying imaging utilization trends on common
diseases using a single institution data2021. More recently, he received dedicated training on the use and
mining of the Pediatric Health Information System (PHIS) database. There is dedicated office space and
protected research time to devote to this project. The database and statistical packages for use in analyses
of this project will be housed on a department PC. All members of the research team work closely together
both in intellectual capacity and physical proximity within the hospital, making collaboration on research
very convenient.
This research will take place within the Department of Diagnostic Imaging and Radiology within Children’s
National Health System. The Department of Diagnostic Imaging and Radiology has received the ACR Gold
Seal of Accreditation in Magnetic Resonance Imaging, Ultrasound, Computed Tomography, and Nuclear
Medicine. The Department houses physicians, board certified pediatric radiologists, technologists,
pediatric anesthesiologists, nurses, and numerous research faculty and staff.
Additional
Available resources in the hospital include statistical software licenses (SAS and
Information:
STATA), access to the PHIS database, biostatisticians familiar with large health
claims dataset analysis, epidemiologists and public health experts, and the Child
Health Advocacy Institute’s Child Health Data Lab, which is a major player in
driving advocacy priorities in the Washington, DC metropolitan area.
Fiscal
Children’s National Health Systems
Agent/Institution
Award Payee First
Hansel
Name
Award Payee Middle
J
Initial
Award Payee Last
Otero
Name
Award Payee Title
Director Body MRI services
Checks payable to:
Hansel J Otero
Award Payee Address
111 Michigan Ave
Washington, DC 20010
United States
Award Payee Phone
(202) 476-4252
Number
Award Payee Email
hotero@childrensnational.org
Grant Administrator's
Charles
First Name
Grant Administrator's
Maris
Last Name
Grant Administrator's
Director, Grants and Contracts
Title
Grant Administrator's
Department
Grant Administrator's
Children’s Research Institute
Address
801 Roeder Rd., Suite 500
Silver Spring, MD 20910
United States
Grant Administrator's
(301) 565-8483
Phone Number
Grant Administrator's
cmaris@childrensnational.org
Email
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Vitae
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(Upload) Mentor/CoInvestigators
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