Clinical usefulness of the Ottawa Ankle Rules in the overweight and obese population following an acute ankle injury: A prospective cross-sectional study
Bibliographic record
Abstract
OBJECTIVE: The aim of this study was to determine the clinical usefulness of the Ottawa Ankle Rules (OAR) in overweight and obese patients compared to the general population. METHODS: In this prospective cross-sectional study, 935 adult patients (453 female, 482 male; mean age = 57.2 ± 20.9) admitted to the emergency department following an acute ankle injury (<3 days) secondary to low energy-trauma were included. All the patients were examined based on a standardized protocol, including age, Body-Mass Index (BMI), OAR, and presence of ankle fracture. As accuracy indicators, sensitivity, specificity, positive and negative predictive values of OAR were calculated. RESULTS: Of all patients, 790 (84.5%) were normal weighted, 107 (11.5%) were overweight, and 38 (4%) were obese. While OAR was negative in 58.8% of patients, 41.2% of patients met OAR. The sensitivity of OAR in the normal weighted population was significantly higher than obese and overweight groups (P < 0.01). The specificity of OAR in the normal weighted population was significantly lower than overweight and obese groups (P < 0.01). The accuracy of OAR in the overweight group was 82.7% and significantly higher compared with the normal weighted population (62.8%) (P < 0.01). CONCLUSION: We do not recommend OAR as a screening tool to be used safely in patients with higher BMI because of its lower sensitivity in this population. In this specific patient population, these rules should be implemented carefully, and radiography should be evaluated meticulously not to miss a fracture. LEVEL OF EVIDENCE: Level IV, Cross Sectional Study.
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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 | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".