Abstract: Background: It is unclear whether the use of pacification strategies before MR scanning can improve the examination cooperation of children in a non-sedated state. Objective: To explore the effectiveness of an intelligent pacification strategy information system based on assisted decision-making in reducing the sedation rate of short-term MR scans in preschool children. Design: Quality improvement study. Methods: Patients at the age of 3-5 years were enrolled from those who attended the outpatient (excluding emergency) and inpatient MR appointments in the Radiology Department at the Xiamen Branch of Children's Hospital of Fudan University. Regular plain scans of common parts were performed with conventional sequences, and the total scanning time was about 10 minutes. Those who were unable to communicate and maintain a quiet state due to mental or psychological illness or intellectual disability were excluded and those who needed urgent MR examination due to acute and severe illness without time and conditions to receive pacification were excluded. Before the quality improvement, specialists at pacification made a plan based on their own experience and discussion with the family member. After the quality improvement, the intelligent pacification strategy information system was used to assist the decision-making. Accompanied by the pacification specialist to perform the plan, patients first received the simulated MR scan. If they succeeded in finishing the scan, a formal MR scan was performed. If the simulated MR failed twice, or patients failed to receive formal MR, patients would be sedated with medication to complete the scan. The pacification success rate, pacification time, and image quality were compared before and after quality improvement. Main outcome measures: The pacification success rate. Results: One hundred and twenty-five children aged 3 to 5 years were included, with 62 before improvement and 63 after improvement. There were 65 males (52%). Simulated MR was completed by pacification in 111 cases, 52 before improvement and 59 after improvement, and formal MR was completed by pacification in 99 cases, 46 before improvement and 53 after improvement. A total of 26 cases completed MR after sedation by enema, 16 cases before improvement, and 10 cases after improvement. The pacification success rate after quality improvement was higher than that before(84.1% vs 74.2%), and the pacification time was shorter than that before ［ (42.91±5.43) min vs (54.35±7.02) min］. The differences were statistically significant. There was no statistically significant difference in image quality between the success subgroup and the failure subgroup as well as before and after improvement. Conclusions: The application of an intelligent pacification strategy information system based on assisted decision-making can help reduce the use of sedative drugs in preschool children during short-term MR scans and improve the efficiency of pacification.

Key words: Pacification strategies, Information systems, Assisted decision-making, Children, Magnetic resonance