Reasons for increased number of x-rays done in emergency department for injuries. A dilemma of delay and overcrowding
Bibliographic record
Abstract
Background: In the past 3 years, average length of stay in the emergency department has increased by 20–30%. It was found that one of the most important factor causing this was increased number of X-rays done. At an average one x-ray adds 4–5 hours to disposition time. An observational study was done to find out reasons for the low compliance with usage of Ottawa ankle rules. Methods: Initially observational study was done where 100 physicians were observed while they examine ankle and foot sprain cases for requesting x-ray. This was done without their knowledge. Then a questionnaire was distributed among 100 Emergency doctors to determine the factors that lead to non-compliance with use of Ottawa rules as screening tool for requesting x-ray. Result: In the initial observational study done on 100 cases we found that, only 20 patients presenting with symptoms of ankle /foot injury had bony injury ruled out by Ottawa rules and in 11 out of these, Ottawa rule was not done appropriately. The questionnaire was completed by 100 physicians. The result showed that 64% of physicians were afraid of the liability of missing fracture. 56% were not comfortable because of difficulty in follow up. 24% expressed that increased number of patients with limited time to assess patient thoroughly put a pressure to do X-ray. 48% were not aware of Ottawa rules. 32% mentioned that lack of emergency follow-up clinics for those with persistent symptoms compel them to request x-rays than to decide clinically. Conclusion: A proper follow-up system for patients discharged after screening will reduce the fear of liability of missing fractures. This will reduce the number of x-rays and length of stay in ED.
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 | 0.002 | 0.006 |
| 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 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".