ArticleCureus2025
System-Level Barriers to National Institute for Health and Care Excellence (NICE) Guideline Compliance in Distal Radius Fracture Management: A Retrospective Audit Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Distal radius fractures are among the most common orthopaedic injuries, particularly in the elderly population. The UK's National Institute for Health and Care Excellence (NICE) provides clear management guidelines, yet adherence remains inconsistent. This quality improvement project evaluated and enhanced compliance with NICE standards for the management of dorsally angulated distal radius fractures at University Hospitals Birmingham NHS Foundation Trust, a major trauma centre in Birmingham, United Kingdom. Methods A two-cycle audit was undertaken using the Plan-Do-Study-Act (PDSA) framework. Cycle 1 (May-August 2020) retrospectively reviewed 30 adults to assess compliance with NICE recommendations for manipulation. Following an educational intervention, Cycle 2 (June-August 2023) evaluated 43 adults requiring surgery, focusing on compliance with NICE surgical timing standards. Data were obtained from electronic patient records. Results In Cycle 1, 90% (27/30) of patients received manipulation in the emergency department (ED), indicating good baseline compliance. In Cycle 2, only 11.6% (5/43) underwent surgery within the NICE-recommended timeframe - 10% (4/40) for intra-articular fractures (target ≤ 72 hours) and 33.3% (1/3) for extra-articular fractures (target ≤ 7 days). The mean time to surgery was 8.6 days for intra-articular and 6.3 days for extra-articular fractures. Limited theatre capacity accounted for 73.7% (28/38) of delays. Conclusions Educational measures improved awareness but did not resolve system-level barriers. Theatre capacity and list allocation remain the main obstacles to timely surgical management. Achieving full compliance with NICE guidance requires combining educational reinforcement with structural and resource-based solutions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.