ED Neuroimaging Utilization Rises Across All Ages and U.S. Regions, 2016–2025

ED neuroimaging use rose across all ages and U.S. regions from 2016–2025, largest absolute increase in adults ≥65 (from 377.5 to 592.6 per 1,000 encounters). All trends p<.001. Retrospective Epic Cosmos data.

• Retrospective analysis of aggregate deidentified ED encounter data from the Epic Cosmos network, 2016–2025; exact number of encounters not reported in source.
• Regional absolute increases ranged from +110.2 per 1,000 encounters in the West to +162.3 in the Northeast; annual incidence rate ratios 1.05–1.07 across regions (all p<.001).
• Limitation: Retrospective, aggregate data from a self-selected network of Epic Cosmos organizations; generalizability may be limited by changes in network composition over time.

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