stiell i, et al
jama
march 3, 1993
2 university emergency rooms
ottawa and toronto, canada
ankle xrays.
it matters! ankle pain is one of the most common ED complaints!
...and only 15% of those getting xrays are POSITIVE
the study validated and refined previously derived clinical decision rules
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stage I
validate and refine the original rules
stage II
validate the refined rules
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n (stage I) = 1032 of 1130 available patients
n (stage II) = 453 of 530 available patients
stage I: original rules:
sensitivity: 1.0 (95% CI, 0.97 to 1.0) for detecting 121 malleolar zone fx & 0.98 (95% CI, 0.88 to 1.0) for detecting 49 midfoot zone fx
stage II: refined rules:
sensitivity: 1.0 (95% CI, 0.93 to 1.0) for detecting 50 malleolar zone fx & 1.0 (95% CI, 0.83 to 1.0) for detecting 19 midfoot zone fx
