Use of the Ottawa Ankle Rule by Paramedics in the Out-of-Hospital Setting
Bibliographic record
Abstract
Objective The Ottawa Ankle Rule (OAR) is extensively documented in the emergency department setting and has been subjected to repeated validation. However, the prehospital experience in implementing this clinical decision rule appears poorly described. The objective of this study is to identify evidence (of any level) describing the use of the OAR by paramedics. Methods A literature search was conducted of the following key electronic databases; Medline (1950 to March Week 1 2010); EMBASE (1980-Week 10 2010) and CINAHL (1981-March 2010). The keywords ‘ankle injury’, ‘clinical decision rule’, ‘paramedic’, ‘ambulance’, ‘prehospital’, and ‘emergency care’ were used to frame the search, while a prehospital and emergency care search filter was used to maximise the sensitivity of the search. A review was conducted of the reference lists accompanying each relevant article to identify other potentially relevant citations. The search criteria included published articles which were both primary research and secondary review papers, and conference abstracts of any research design. We excluded non-English articles and letters. The abstracts of all citations in the search results were reviewed and full text articles for studies of interest were retrieved for examination. Results The search yielded 98 citations, with 80 relating directly to the OAR. After reviewing the abstracts of all citations, no articles of any study design, discussing the use of the OAR by paramedics in the out-of-hospital setting were identified. Conclusion Whilst there is no published evidence describing the use of the OAR by paramedics in the prehospital setting, it is feasible that paramedics could implement the rule safely and with equivalent sensitivity and specificity to other settings. This clinical decision rule may have good utility as a triage tool that could be used to stream suitable patients into non-emergency department alternatives. Research is needed to validate the use of the OAR when used within EMS jurisdictions.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".