Ottawa Ankle Rule: An Indian Perspective
Bibliographic record
Abstract
ABSTRACT Introduction Foot and ankle injuries are common clinical conditions treated by orthopedic surgeons accounting for 6 to 12% of the patients seen in emergency. Currently, almost all patients with foot and ankle injuries undergo radiographic examination to exclude fractures; however, fewer than 15% of these patients actually have fractures, thus, most of these radiographs are unnecessary. Unwarranted radiographic examination increases the demands on the healthcare system and also results in prolonged patient waiting times. Ottawa ankle rule (OAR) evolved to reduce the number of radiography and waiting time for patients in emergency department by excluding fractures using only clinical examination. Although, it has good sensitivity but it has not been much popular and not included in medical curriculum. Aim The aim of the study is to implement the OAR in an Indian tertiary care trauma setup with two different levels of clinical examiners (1st year postgraduate junior resident and senior resident) and report the finding. Materials and methods This prospective study was done in the Department of Orthopedics, for a period of 15 months. Clinical examiners were shown and given a video presentation about the Oar and a printed copy of the rules were provided to all. Clinical diagnosis of both levels of clinical examiners were evaluated and analyzed. Results Three hundred cases met our inclusion criteria. In first clinical examination done by junior resident, 115 clinically significant fractures were suspected while senior resident suspected 69 fractures. Radiography showed 5 cases with missed fractures. Accuracy of OAR by JR is 82.33% and by SR is 97.0%. Conclusion Ottawa ankle rule are very effective and can identify all clinically relevant fractures of ankle and foot with increased accuracy and sensitivity when applied by a trauma specialists. Although, these rules can also be applied by general doctors so as to help them to screen patients who need radiography in acute ankle injury, but it is more sensitive when it is applied by specialist doctor. How to cite this article Singh S, Kumar D, Yadav AK. Ottawa Ankle Rule: An Indian Perspective. J Foot Ankle Surg (Asia- Pacific) 2015;2(1):8-12.
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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 | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| 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".