Evidence map›Paper›PMID 37957570›Full record

ReviewInternational journal of emergency medicine2023

Awareness and use of five imaging decision rules for musculoskeletal injuries: a systematic review.

Priti Kharel, Joshua R Zadro, Zhang Chen, Madii A Himbury, Adrian C Traeger, James Linklater, Christopher G Maher

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in International journal of emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Priti KharelSydney Musculoskeletal Health, The University of Sydney, Royal Prince Alfred Hospital, Level 10 North, King George V Building, Missenden Road, PO Box M179, Sydney, NSW, 2050, Australia. priti.kharel@sydney.edu.au.
Joshua R ZadroSydney Musculoskeletal Health, The University of Sydney, Royal Prince Alfred Hospital, Level 10 North, King George V Building, Missenden Road, PO Box M179, Sydney, NSW, 2050, Australia.
Zhang ChenSydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Madii A HimburySydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Adrian C TraegerSydney Musculoskeletal Health, The University of Sydney, Royal Prince Alfred Hospital, Level 10 North, King George V Building, Missenden Road, PO Box M179, Sydney, NSW, 2050, Australia.
James LinklaterCastlereagh Imaging, Sydney, NSW, Australia.
Christopher G MaherSydney Musculoskeletal Health, The University of Sydney, Royal Prince Alfred Hospital, Level 10 North, King George V Building, Missenden Road, PO Box M179, Sydney, NSW, 2050, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral validated decision rules are available for clinicians to guide the appropriate use of imaging for patients with musculoskeletal injuries, including the Canadian CT Head Rule, Canadian C-Spine Rule, National Emergency X-Radiography Utilization Study (NEXUS) guideline, Ottawa Ankle Rules and Ottawa Knee Rules. However, it is unclear to what extent clinicians are aware of the rules and are using these five rules in practice.

objectiveTo determine the proportion of clinicians that are aware of five imaging decision rules and the proportion that use them in practice.

designSystematic review.

methodsThis was a systematic review conducted in accordance with the 'Preferred reporting items for systematic reviews and meta-analyses' (PRISMA) statement. We performed searches in MEDLINE (via Ovid), CINAHL (via EBSCO), EMBASE (via Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and Scopus databases to identify observational and experimental studies with data on the following outcomes among clinicians related to five validated imaging decision rules: awareness, use, attitudes, knowledge, and barriers and facilitators to implementation. Where possible, we pooled data using medians to summarise these outcomes.

resultsWe included 39 studies. Studies were conducted in 15 countries (e.g. the USA, Canada, the UK, Australasia, New Zealand) and included various clinician types (e.g. emergency physicians, emergency nurses and nurse practitioners). Among the five decision rules, clinicians' awareness was highest for the Canadian C-Spine Rule (84%, n = 3 studies) and lowest for the Ottawa Knee Rules (18%, n = 2). Clinicians' use was highest for NEXUS (median percentage ranging from 7 to 77%, n = 4) followed by Canadian C-Spine Rule (56-71%, n = 7 studies) and lowest for the Ottawa Knee Rules which ranged from 18 to 58% (n = 4).

conclusionOur results suggest that awareness of the five imaging decision rules is low. Changing clinicians' attitudes and knowledge towards these decision rules and addressing barriers to their implementation could increase use.

Indexed as

Canadian C-Spine RuleCanadian CT Head RuleNEXUS guidelinesOttawa Ankle RulesOttawa Knee Rules

Identifiers

PMID37957570
PMCPMC10644430

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.