Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study

Abstract

National Health and Medical Research Council, Emergency Medicine Foundation, Perpetual Philanthropic Services, WA Health Targeted Research Funds, Townsville Hospital Private Practice Fund, Auckland Medical Research Foundation, A + Trust.

Validation and refinement of a clinical decision rule for the use of computed tomography in children with minor head injury in the emergency department

“…patients were lost to follow-up, this rate is similar to those of other large prospective emergency department studies of head injury in children, such as the studies by Kuppermann and colleagues 29 and Babl and colleagues, 30 which had lost-to-follow-up rates of 21% and 10%, respectively. Although the interobserver agreement (κ = 0.67) for the CATCH rule is considered moderate to substantial, [31][32][33] future implementation studies should focus on improving this.…”

“…Babl and colleagues 30 recently published a well-designed prospective external validation of the CATCH, 6 PECARN 29 and CHALICE (Children's Head Injury Algorithm for the Prediction of Important Clinical Events) 27 rules. They reported a high sensitivity (95.2%, 95% CI 76.2%-99.9%) for the CATCH rule, which predicted 20 of 21 patients requiring neurosurgical intervention.…”

Accuracy of NEXUS II head injury decision rule in children: a prospective PREDICT cohort study

“…Any changes in definitions and wording of head injury rules have the potential to alter the final results 23. The focus of the parent study11 used for this paper, however, was on the paediatric-specific CATCH, CHALICE and PECARN rules 6–8. We felt that by collecting the predictor and outcome variables of three rules in detail, the modified definitions could be closely approximated to the actual NEXUS II criteria used for this study.…”

“…While the focus of the parent study11 was on the validation of three other paediatric-specific neuroimaging rules ((i) the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury developed by the Paediatric Emergency Care Applied Research Network (PECARN),6 (ii) the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) rule7 and (iii) the Children’s Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE))8 published elsewhere,11 we also collected the predictor and outcome variables of the NEXUS II rule 9 10. Using the published predictor variables and ICI as outcome variable as defined by NEXUS, we assessed the accuracy (sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV)) of NEXUS II in patients in the whole cohort of patients, using systematic telephone follow-up data as a surrogate for negative primary outcome of no ICI if no CT scan had been performed.…”

Penetrating head injuries in children presenting to the emergency department in Australia and New Zealand: A PREDICT prospective study

“…Of the 10 study EDs, 8 were located at tertiary children's hospitals, and 7 of the 10 sites were regional paediatric trauma centres. The parent study was conducted to assess the accuracy of three HI clinical decision rules with details described elsewhere …”