#CERVICAL SPINE X RAY TRIAL#
#CERVICAL SPINE X RAY LICENSE#

Application of this instrument could reduce the use of imaging in such patients. ConclusionsĪ simple decision instrument based on clinical criteria can help physicians to identify reliably the patients who need radiography of the cervical spine after blunt trauma. According to the results of assessment with the decision instrument, radiographic imaging could have been avoided in the cases of 4309 (12.6 percent) of the 34,069 evaluated patients. Only two of the patients classified as unlikely to have an injury according to the decision instrument met the preset definition of a clinically significant injury (sensitivity, 99.6 percent negative predictive value, 99.9 percent specificity, 12.9 percent positive predictive value, 1.9 percent), and only one of these two patients received surgical treatment.

The negative predictive value was 99.8 percent (95 percent confidence interval, 99.6 to 100 percent), the specificity was 12.9 percent, and the positive predictive value was 2.7 percent. The decision instrument identified all but 8 of the 818 patients who had cervical-spine injury (sensitivity, 99.0 percent ). We examined the performance of the decision instrument in 34,069 patients who underwent radiography of the cervical spine after blunt trauma. The decision instrument required patients to meet five criteria in order to be classified as having a low probability of injury: no midline cervical tenderness, no focal neurologic deficit, normal alertness, no intoxication, and no painful, distracting injury. We conducted a prospective, observational study of such a decision instrument at 21 centers across the United States. Previous research suggests that a set of clinical criteria (decision instrument) can identify patients who have an extremely low probability of injury and who consequently have no need for imaging studies. The most trusted, influential source of new medical knowledge and clinical best practices in the world.īecause clinicians fear missing occult cervical-spine injuries, they obtain cervical radiographs for nearly all patients who present with blunt trauma.

#CERVICAL SPINE X RAY LICENSE#

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#CERVICAL SPINE X RAY TRIAL#

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Cervical spine x ray