ArticleSpinal cord2021
Clinical judgment is a cornerstone for validating and using clinical prediction rules: a head-to-head study on ambulation outcomes for spinal cord injured patients.
Article in Spinal cord, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Characterizing ambulation potential following acute traumatic spinal cord injury: a populational cohort study on 1209 patients.Spinal cord · 2026Article
- Rethinking Movement: From Capacity to Context.Kinesiology review (Champaign, Ill.) · 2026Article
- A Single Dermatome Clinical Prediction Rule for Independent Walking 1 Year After Spinal Cord Injury.Archives of physical medicine and rehabilitation · 2024Article
- Are Clinical Prediction Rules Used in Spinal Cord Injury Care? A Survey of Practice.Topics in spinal cord injury rehabilitation · 2024Article
- Article
- Looking Good From the End of Bed: Surgical Clinical Intuition.ANZ journal of surgeryObservational
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designRetrospective comparative study.
objectiveClinical prediction rules (CPRs) are an effervescent topic in the medical literature. Recovering ambulation after a traumatic spinal cord injury (tSCI) is a priority for patients and multiple CPRs have been proposed for predicting ambulation outcomes. Our objective is to confront clinical judgment to an established CPR developed for patients with tSCI. SETTINGS: Level one trauma center specialized in tSCI and its affiliated rehabilitation center.
methodIn this retrospective comparative study, six physicians had to predict the ambulation outcome of 68 patients after a tSCI based on information from the acute hospitalization. Ambulation was also predicted according to the CPR of van Middendorp (CPR-vM). The success rate of the CPR-vM and clinicians to predict ambulation was compared using criteria of 5% for defining clinical significance, and a level of statistical significance of 0.05 for bilateral McNemar tests.
resultsThere was no statistical difference between the overall performance of physicians (success rate of 79%) and of the CPR-vM (81%) for predicting ambulation. The differences between the CPR-vM and physicians varied clinically and significantly with the level of experience, clinical setting, and field of expertise.
conclusionConfronting CPRs with the judgment of a group of clinicians should be an integral part of the design and validation of CPRs. Head-to-head comparison of CPRs with clinicians is also a cornerstone for defining the optimal strategy for translation into the clinical practice, and for defining which clinician and specific clinical context would benefit from using the CPR.
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