ArticlePediatric radiology2016
A clinical decision rule for the use of plain radiography in children after acute wrist injury: development and external validation of the Amsterdam Pediatric Wrist Rules.
Article in Pediatric radiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis.PloS one · 2016Pooled it
- Collaborating with non-radiological clinical colleagues.Pediatric radiology · 2025Review
- Fracture sonography-review of literature and current recommendations.Archives of orthopaedic and trauma surgery · 2024Review
- Development and validation of the paediatric elbow trauma (PET) rules as a decision rule for radiography in traumatic elbow injuries: a study protocol.BMJ paediatrics open · 2023Article
- Detecting scaphoid fractures in wrist injury: a clinical decision rule.Archives of orthopaedic and trauma surgery · 2020Article
- Implementation of the Amsterdam Pediatric Wrist Rules.Pediatric radiology · 2018Article
- [X‑ray of the thoracic and lumbar spine in injured children and adolescents : Incidence, fracture rates and therapeutic consequences].Der Unfallchirurg · 2018Article
- Number of positive radiographic findings in pediatric trauma patients.Emergency radiology · 2017Article
- External validation of clinical decision rules for children with wrist trauma.Pediatric radiology · 2017Article
- A clinical decision rule for the use of ultrasound in children presenting with acute inflammatory neck masses.Pediatric radiology · 2017Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn most hospitals, children with acute wrist trauma are routinely referred for radiography.
objectiveTo develop and validate a clinical decision rule to decide whether radiography in children with wrist trauma is required. MATERIALS AND
methodsWe prospectively developed and validated a clinical decision rule in two study populations. All children who presented in the emergency department of four hospitals with pain following wrist trauma were included and evaluated for 18 clinical variables. The outcome was a wrist fracture diagnosed by plain radiography.
resultsIncluded in the study were 787 children. The prediction model consisted of six variables: age, swelling of the distal radius, visible deformation, distal radius tender to palpation, anatomical snuffbox tender to palpation, and painful or abnormal supination. The model showed an area under the receiver operator characteristics curve of 0.79 (95% CI: 0.76-0.83). The sensitivity and specificity were 95.9% and 37.3%, respectively. The use of this model would have resulted in a 22% absolute reduction of radiographic examinations. In a validation study, 7/170 fractures (4.1%, 95% CI: 1.7-8.3%) would have been missed using the decision model.
conclusionThe decision model may be a valuable tool to decide whether radiography in children after wrist trauma is required.
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