Validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk patients with blunt trauma to the neck: part 2. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration

Moser, Nicholas; Lemeunier, Nadège; Southerst, Danielle; Shearer, Heather M.; Murnaghan, Kent; Sutton, Deborah; Côté, Pierre

doi:10.1007/s00586-017-5301-6

Cited by 13 publications

(10 citation statements)

References 36 publications

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“…The literature screening filtered by systematic reviews and metanalyses led to 1.166 results. Among these, we found relevant in order to add more evidence to our comparison nine studies [1,2,[9][10][11][12][13][14][15][16].…”

Section: Resultsmentioning

confidence: 99%

“…Both used X-ray as the reference standard to identify cervical spine lesion, while different studies show that computed tomography (CT) has higher diagnostic accuracy and it is now considered the reference standard. In the literature, few validation and comparison studies of the two rules are available [11][12][13][14]. The CCR seems to be more accurate than the NEXUS and clinical judgment [15], but further studies are needed.…”

Section: Literature Search and Fields For Future Researchmentioning

confidence: 99%

“…Based on the literature, the most common sites of injury are the second cervical vertebra (C2, or axis, 33%) and the region of the three vertebrae C5, C6, and C7 (50%) [ 11 , 12 ]. The level of the cervical spine lesion correlates to the severity of the outcome (the higher the lesion, the worse the outcome, from death to quadriplegia, paraplegia or other disabling conditions) [ 1 ].…”

Section: Question 5 How Many and Which Segments Of The Cervical Spine Need To Be Investigated?mentioning

confidence: 99%

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Management of patients with cervical spine trauma in the emergency department: a systematic critical appraisal of guidelines with a view to developing standardized strategies for clinical practice

et al. 2021

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Several guidelines on the evaluation of patients with suspected cervical spine trauma in the Emergency Department (ED) exist. High heterogeneity between different guidelines has been reported. Aim of this study was to find areas of agreement and disagreement between guidelines, to identify topics in which further research is needed and to provide an evidence-based cervical spine trauma algorithm for ED physicians. The three most relevant guidelines published on cervical spine trauma in the last 10 years were selected screening websites of the main scientific societies and through the comparison of a normalized Google Scholar and SCOPUS citation index. We compared the selected guidelines through seven a-priori defined questions. In case of disagreement between the guidelines or if the quality of evidence appeared low, evidence from published systematic reviews on the topic was added to build an evidence-based algorithm for approach to spinal trauma in the ED. The three selected guidelines were: NICE 2016, Eastern Association for the Surgery of Trauma 2009 and American Association of Neurological Surgeons and Congress of Neurological Surgeons 2013. We found complete agreement on one question, partial agreement for one questions, no agreement for two questions, while agreement was not assessable for 3 questions. The agreement between different guidelines and the evidence on which recommendations are based is low. An attempt to build an evidence-based algorithm has been made. More studies are needed on many topics.

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Section: Resultsmentioning

confidence: 99%

Section: Literature Search and Fields For Future Researchmentioning

confidence: 99%

Section: Question 5 How Many and Which Segments Of The Cervical Spine Need To Be Investigated?mentioning

confidence: 99%

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Management of patients with cervical spine trauma in the emergency department: a systematic critical appraisal of guidelines with a view to developing standardized strategies for clinical practice

et al. 2021

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“…Quizás esta sea la razón del uso excesivo de los estudios por imágenes en los servicios de urgencias. 11 El examen clínico y las reglas de predicción, como la Canadian C-Spine Rule, 12 se deberían poder utilizar para evaluar a pacientes con politraumatismos, vigiles y sin deterioro neurológico, a fin de determinar si son necesarios los estudios por imágenes complementarios. De esta manera, se podría brindar una atención segura, basada en la evidencia y costo-eficaz a los pacientes con politraumatismos.…”

Section: Discussionunclassified

Evaluación de lesiones de la columna cervical en pacientes con politraumatismos, en el Servicio de Urgencias

Frank¹,

Cavallaro²,

Sanchez³

et al. 2021

Rev. Asoc. Arg. Ort. y Traumatol

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Introducción: Tradicionalmente se ha recurrido al examen clínico-neurológico y a los estudios por imágenes para identificar lesiones de la columna cervical en pacientes con politraumatismos. En diferentes centros de trauma, la evaluación inicial de estos pacientes incluye un examen clínico-neurológico más radiografías obligatorias, independientemente de una semiología normal, en un paciente despierto y consciente. Esto se debe a la creencia de que el examen clínico es insuficiente para detectar estas lesiones. Materiales y Métodos: Se trata de un estudio transversal y observacional para determinar la sensibilidad y la especificidad de la evaluación clínica para el diagnóstico de lesiones de la columna cervical comparadas con las de los estudios por imágenes, en un período de 22 meses, en un Servicio de Urgencias. Resultados: Durante este período, se asistió a 127 pacientes. El examen físico neurológico fue normal en 101 pacientes, ninguno tenía una lesión constatada en las radiografías o las imágenes tomográficas. Veintiséis pacientes refirieron dolor a la palpación de las apófisis espinosas; en 6 de ellos, se constató una lesión de la columna cervical con la tomografía. La sensibilidad del examen físico fue del 100% y la especificidad, del 83%. La tasa de falsos positivos fue del 17% y no se registró ningún falso negativo. Conclusiones: Los datos de este estudio demuestran que la mayoría de los estudios por imágenes, radiografías o tomografías computarizadas podrían disminuirse, sin perder la sensibilidad del diagnóstico de lesiones de la columna cervical, reduciendo así los costos de la atención.Nivel de Evidencia: IV

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“…Imaging is indicated in the initial assessment of patients with acute neck pain when myelopathy, suspicion of significant ligamentous injury, or presence of other red flags is noted. 59 In those cases, computed tomography or MRI without contrast are procedures of choice. 57 Plain film radiography is indicated by the National Emergency X-Radiography Utilization Study criteria.…”

Section: Diagnostic Imaging: General Considerationsmentioning

confidence: 99%

Best-Practice Recommendations for Chiropractic Management of Patients With Neck Pain

Whalen

Farabaugh²,

Hawk

et al. 2019

Journal of Manipulative and Physiological Therapeutics

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Objective: The purpose of this study was to develop best-practice recommendations for chiropractic management of adults with neck pain. Methods: A steering committee of experts in chiropractic practice, education, and research drafted a set of recommendations based on the most current relevant clinical practice guidelines. Additional supportive literature was identified through targeted searches conducted by a health sciences librarian. A national panel of chiropractors representing expertise in practice, research, and teaching rated the recommendations using a modified Delphi process. The consensus process was conducted from August to November 2018. Fifty-six panelists rated the 50 statements and concepts and reached consensus on all statements within 3 rounds. Results: The statements and concepts covered aspects of the clinical encounter, ranging from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral for patients presenting with neck pain. Conclusions: These best-practice recommendations for chiropractic management of adults with neck pain are based on the best available scientific evidence. For uncomplicated neck pain, including neck pain with headache or radicular symptoms, chiropractic manipulation and multimodal care are recommended.

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Validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk patients with blunt trauma to the neck: part 2. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration

Cited by 13 publications

References 36 publications

Management of patients with cervical spine trauma in the emergency department: a systematic critical appraisal of guidelines with a view to developing standardized strategies for clinical practice

Management of patients with cervical spine trauma in the emergency department: a systematic critical appraisal of guidelines with a view to developing standardized strategies for clinical practice

Evaluación de lesiones de la columna cervical en pacientes con politraumatismos, en el Servicio de Urgencias

Best-Practice Recommendations for Chiropractic Management of Patients With Neck Pain

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