Comparision of NexusII,New Orleans and Canada cranial CT rules in Head Trauma Patients: A retrospective study.
Notice bibliographique
Résumé
The imaging method of choice to precisely diagnose intracranial injuries is a head CT scan.During recent years the usage of CT in EDs has increased greater than before.Although there is a consensus to scan patients with moderate or severe head trauma urgently, an ongoing debate continues as to which patients with mild head injury should be scanned.In our study we aimed to compare the clinical effects of CCHR, NOC, and NEXUS-II rules to identify the clinically significant brain injuries.Our research was performed at a single Training and Research hospital with 200.000 annual ED visits.Acute mild head injury was defined as a closed head injury by blunt force within 24 hours, with a Glasgow Coma Scale (GCS) score of 13 to 15.All patients who visited our ER with minor head trauma were enrolled in study prospectively, and all CCHR, NOC, and NEXUS rules were evaluated separately for each patient.The determined outcome lesions were subarachnoid haemorrhage, subdural hematoma, contusion, epidural hematoma, skull fracture, intraparenchymal haemorrhage, and cerebral oedema.The sensitivity, specificity, and predictive values with 95% confidence intervals (CIs) for the performance of each rule for CT scan and each criterion of rules and all symptoms predicted to be caused by head trauma were calculated.P < 0.05 was considered statistically significant.A total of 140 patients were included in the study.The mean age of the patients included in the study was 55.59 ± 23.258 (median 57.00)years .Of all patients, 62.1% (n: 87) were male and 37.9% (n: 53) were female.In terms of gender, it was found that men had more minor head trauma.The mean age of male patients was 49.90 and 64.94 for female patients.Among whole study population, 43.57% (n = 61) of the patients were 65 years and older.Sensitivity, specificity, and positive predictive value negative predictive value of NOC were 87.5%, 6.57%, 44.09% and 38.46%, respectively.The sensitivity of CCHR rule was 82.81%, its specificity was 32.8%, its positive predictive value was 50.96%, and its negative predictive value was 69.4%.The sensitivity of NEXUS II rule was 93.75%, specificity was 3.94%, positive predictive value was 45.11%, and the negative predictive value was 42.85%.There are different interpretations in the literature about which rule should be used to decide performing a CT scan in patients with minor head trauma.Additional studies may be demonstrated by focusing specifically on the sensitivity and specificity of each criterion separately.Additionally, more studies should be performed especially in geriatric population to specify a criterion for each rule separately.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».