Unbound MEDLINE

Developing a clinical decision instrument to rule out intracranial injuries in patients with minor head trauma: methodology of the NEXUS II investigation. Annals of emergency medicine. [Ann Emerg Med] Journal article

 
TitleDeveloping a clinical decision instrument to rule out intracranial injuries in patients with minor head trauma: methodology of the NEXUS II investigation.
Author(s)Mower WR, Hoffman JR, Herbert M, Wolfson AB, Pollack CV, Zucker MI, NEXUS II Investigators. National Emergency X-Radiography Utilization Study 
InstitutionUCLA Emergency Medicine Center, UCLA School of Medicine, Los Angeles, CA 90024, USA. wmower@ucla.edu
SourceAnn Emerg Med 2002 Nov; 40(5):505-14.
MeSHBrain Injuries
Decision Support Systems, Clinical
Emergency Medical Services
Emergency Service, Hospital
Head Injuries, Closed
Humans
Multicenter Studies
Prospective Studies
Reproducibility of Results
Research Design
Research Support, U.S. Gov't, P.H.S.
Tomography, X-Ray Computed
Unnecessary Procedures
AbstractThe fear of failing to identify brain injury has led to the liberal and potentially excessive use of computed tomographic (CT) scanning of patients with blunt head trauma who have even a remote possibility of intracranial injury. This practice exposes large numbers of patients to the expense and radiation exposure associated with CT imaging while detecting injuries in a small minority. Previous studies suggest that it might be possible to develop a decision instrument to identify patients with blunt head injury who have essentially no risk of significant intracranial injury and for whom CT scanning is therefore unnecessary. Development of such a decision instrument has been identified as a priority among practicing emergency physicians. The National Emergency X-Radiography Utilization Study II (NEXUS II) is a large, multicenter, prospective study designed to derive a decision rule for CT imaging of patients with blunt head injury. This study, conducted in 21 different emergency departments across the United States and Canada, will enroll more than 10 times as many patients with head trauma as any currently published study. NEXUS II should be able to definitively answer questions about the validity and reliability of clinical criteria as a preliminary screen for blunt head trauma.
Languageeng
Pub Type(s)Journal Article
PubMed ID12399794
  
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