Diagnostic management strategies for adults and children with minor head injury: a systematic review and an economic evaluation

Abstract

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Cancer occurrence among women resident in the Gorizia province (North-Eastern Italy). May ecological data be used for adjusted epidemiological measures? Deterministic and probabilistic sensitivity analysis

“…Although the advantages of the probabilistic sensitivity analysis upon the conventional approach have been already highlighted [2,[4][5][6], it's worth to note that, differently from the deterministic sensitivity analysis, the probabilistic analysis requires the investigator to explicitly definethe uncertainty around the bias parameters, througha prior distribution. This prior distribution may arise from available background information as well as from the personal judgment of the researcher.…”

“…Probabilistic sensitivity analysis, through Monte Carlo simulations, allowed to define several probability density functions for the risk factors and to use these prior distributions to calculate limits for the bias-adjusted exposure-disease relative risks (RRs) [2,4,5]. The term RR is here used as a generic term for the risk ratio, the rate ratio or odds ratio.…”

“…This multidimensional SA permits, therefore, an external adjustment of the effect measures, under different scenarios of confounding, even if it provides none or scarce information of the most likely adjusted estimate. Moreover, both simple and multidimensional SA address only one confounder at a time and, due to the absence of hypothesis about the prior distributions of the bias parameters, do not explicitly account for uncertainty [2,3].…”

Role of headache management in minor head injury before performing brain CT scan - can intravenous morphine sulfate predict intracranial injury?

“…[3,4,6,9,[19][20][21] The Canadian CT Head Rule (CCHR) [3] and the New Orleans Criteria (NOC) [6] are among the most widely studied decision rules. [8,[22][23][24][25][26][27] Headache is a very prevalent symptom in the victims of MHI. [28,29] There is no consensus if headache is a reliable indicator of intracranial injury in these patients.…”

“…[3] For instance, it has been shown that the presence of isolated contusion in CT images of patients with MHI without any other space occupying lesions does not worsen the short term prognosis and does not increase the need for neurosurgical operations. [7] Moreover, precluding unnecessary CT scanning can significantly reduce health care expenditure [6] and resource use, as well as minimizing radiation exposure, [8] saving time, and preventing unnecessary transfer from centers that CT scan is not available. [9] On the other hand, there is an opposing opinion promoting a more liberal use of CT scan considering the unfavorable outcomes of missing an abnormality.…”