Derivation and validation of two decision instruments for selective chest CT in blunt trauma: a multicenter prospective observational study (NEXUS Chest CT)
Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3/5
Authors: Rodriguez RM, et al. PLoS Med. 2015 Oct 6;12(10):e1001883. Full Article
This study derived and validated a clinical decision rule for CT imaging in blunt thoracic trauma (NEXUS CT Chest rule) that was found to have a sensitivity of 99.2% for “major injury” and 95.4% for “major and minor injury” and a specificity of 25.5% and 31.7% respectively. This study had certain methodological flaws such as including patients with GCS<15 and including independent variables open to interpretation (ex: distracting injury) but does serve to illuminate historical and physical exam findings predictive of significant thoracic injury. By: Dr. Simeon Mitchell
Epi lesson: Validation of Clinical Decision Rules Critical appraisal criteria for a paper that validates an existing decision rule are different than those for a study that derives or creates the rule. Most important is that the study evaluates the existing rule…
Authors: Rodriguez RM, et al. PLoS Med. 2015 Oct 6;12(10):e1001883. Full Article
This study derived and validated a clinical decision rule for CT imaging in blunt thoracic trauma (NEXUS CT Chest rule) that was found to have a sensitivity of 99.2% for “major injury” and 95.4% for “major and minor injury” and a specificity of 25.5% and 31.7% respectively. This study had certain methodological flaws such as including patients with GCS<15 and including independent variables open to interpretation (ex: distracting injury) but does serve to illuminate historical and physical exam findings predictive of significant thoracic injury. By: Dr. Simeon Mitchell
Epi lesson: Validation of Clinical Decision Rules Critical appraisal criteria for a paper that validates an existing decision rule are different than those for a study that derives or creates the rule. Most important is that the study evaluates the existing rule…