March 2014. Volume 10. Number 1

A clinical decision rule reduces unnecessary radiographs in ankle lesions in children

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Boutis K, Grootendorst P, Willan A, Plint AC, Babyn P, Brison RJ, et al. Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries. CMAJ. 2013;185:E731-8.
Reviewers: Esparza Olcina MJ1, Aparicio Rodrigo M2.
1Centro de Salud Barcelona. Móstoles. Madrid. España.
2Centro de Salud Entreví­as. Área 1. Madrid. España.
Correspondence: María Jesús Esparza Olcina. Email: mjesparza8@gmail.com
Reception date: 28/12/2013
Acceptance date: 03/01/2014
Publication date: 19/02/2014

Abstract

Authors’ conclusions: the implementation of the “low risk ankle rule” produces a significant reduction in order of radiographies without increasing the number of non-diagnosed relevant fractures or diminishing patient or physician’s satisfaction.

Reviewers’ commentary: albeit the weaknesses of this study (absence of randomization of participant hospitals and a high number of losses) it appears that the implementation of the “low risk ankle rule” could reduce the use of radiographs in the emergency setting, reducing the radiation to patients as well as the healthcare expenses.

How to cite this article

Esparza Olcina MJ, Aparicio Rodrigo M. Una regla de predicción clínica disminuye el número de radiografías innecesarias en los traumatismos de tobillo. Evid Pediatr. 2014;10:4.

AVC | Critically appraised articles

Boutis K, Grootendorst P, Willan A, Plint AC, Babyn P, Brison RJ, et al. Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries. CMAJ. 2013;185:E731-8.
Reviewers: Esparza Olcina MJ1, Aparicio Rodrigo M2.
1Centro de Salud Barcelona. Móstoles. Madrid. España.
2Centro de Salud Entreví­as. Área 1. Madrid. España.
Correspondence: María Jesús Esparza Olcina. Email: mjesparza8@gmail.com
Reception date: 28/12/2013
Acceptance date: 03/01/2014
Publication date: 19/02/2014

How to cite this article

Esparza Olcina MJ, Aparicio Rodrigo M. Una regla de predicción clínica disminuye el número de radiografías innecesarias en los traumatismos de tobillo. Evid Pediatr. 2014;10:4.

References

  1. Boutis K, Komar L, Jaramillo D, Babyn P, Alman B, Snyder B, et al. Sensitivity of a clinical examination to predict need for radiography in children with ankle injuries: a prospective study. Lancet. 2001;358:2118-21.
  2. Gravel J, Hedrei P, Grimard G, Gouin S, Gravel J, Hedrei P, et al. Prospective validation and head-to-head comparison of 3 ankle rules in a pediatric population. Ann Emerg Med. 2009;54:534-40.
  3. Boutis K, Schuh S. Prospective validation and head-to-head comparison of 3 ankle rules in a pediatric population. Ann Emerg Med. 2010;55:391-2; author reply 392-3.
  4. Cuello-García C, Ruiz-Flores A, Ramos-Gómez L, Medina-López ME. Los criterios de Ottawa para tobillo: valoración en un servicio de urgencias en México. An Pediatr (Barc). 2004;60:454-8.
19/02/2014

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