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Volume 350:1467-1469 April 1, 2004 Number 14
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The Canadian C-Spine Rule

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by Yealy, D. M.
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by Stiell, I. G.
-PubMed Citation
To the Editor: Stiell et al. (Dec. 25 issue)1 report the sensitivity of the National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria (NLC) for important cervical-spine injury to be 90.7 percent. This figure dramatically contrasts with the 99.6 percent sensitivity we observed among more than 34,000 patients examined by hundreds of clinicians in multiple emergency departments, representing real-world practice.2

There are several reasons to believe that the Canadian researchers underestimated the sensitivity of the NLC. As noted by Yealy and Auble3 in their editorial accompanying the report, the use of surrogate criteria by Stiell et al. introduces the potential for . . . [Full Text of this Article]



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