Audit on the use of radiography and the management of ankle sprains in A&E
Bibliographic record
Abstract
Objective: To determine the need for a local implementation strategy of the Ottawa Ankle and Foot rule in the A& E Department of St. Luke' s Hospital, Malta and to examine the current management practices of ankle sprains. Methods: A prospective study was conducted on all patients aged 16 years and over presenting to the A& E department of St. Luke’s Hospital, Malta over a six week period with ankle and midfoot injuries. Data collected included time and mechanism of injury, clinical examination findings, radiographic investigations ordered, management and disposal of patient. Results: Sixty nine (95%) of the 73 patients presenting with ankle injuries underwent x-ray investigation. In total 90 x-ray series (i.e. AP and lateral) were performed, 62 of which were ankle x-rays and 28 were foot x-rays. Clinical application of the Ottawa ankle rules (OAR) would have resulted in a reduction of ankle x-rays by 19.4% and foot x-rays by 32.1%. Management of severe ankle sprains included written discharge instructions in 54% and referrals to physiotherapy in 31%. One patient out of the 13 with severe ankle sprains was given a follow up appointment at Fresh Trauma Clinic (FTC). Conclusion: A local implementation strategy for the OAR in the A& E department may result in an overall reduction in radiographic requests by 21%. An appropriate guideline for management of ankle injuries incorporating the OAR is needed and should be developed using the available evidence base.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 | 0.000 |
| 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".