Clinicians currently order imaging studies for most patientswith blunt head or neck trauma if there is even a remote possibilityof cervical-spine injury, in order to avoid missing a potentiallydisabling fracture, dislocation, or ligamentous injury. Theresult of this practice is that 96 percent or more of cervical-spineradiographs reveal no clinically important injuries.1,2 A decisionrule, or clinical prediction rule, that could reliably identifypatients with trauma who are at very low risk for cervical anatomicaldisruption could help reduce unnecessary radiographic testing,improve efficiency, and decrease health care expenditures thataccompany testing.
From the Department of Emergency Medicine, University of Pittsburgh, Pittsburgh.
Related Letters:
The Canadian C-Spine Rule
Mower W. R., Wolfson A. B., Hoffman J. R., Todd K. H., Hall F. M., Stiell I. G., Rowe B. H., Lee J.
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N Engl J Med 2004;
350:1467-1469, Apr 1, 2004.
Correspondence
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