Canadian C-spine Audit: Appropriateness of C-spine Radiograph Requests in Adult Spinal Injury Assessment ID 10371
Bibliographic record
Abstract
Aims and Objectives: To establish whether a newly instituted head and neck care bundle (a checklist document), following recommendations by the initial audit appropriateness of C-spine Radiograph Requests in Spinal Injury or direct CT C-spine in accordance to NICE guidance NG41 showed an improvement in the use of the correct first time modality (X-ray or CT). Methodology: This was a retrospective study using the CRIS system to evaluate all patients that attended accident and emergency in the months of January and February 2019. Thirty-five patients had C-spine radiographs and 127 patients had C-spine CT scans. The patient were categorised into high and low risk based on NICE guidance NG41 and the use of patient notes via Patient First. Results: Data was collected and compared with the first audit (ID1614). 74.4% of patients received the appropriate first line radiological modality, compared with 90.7% of patients after the newly instituted head and neck bundle. Discussion: High risk patients were supposed to have a CT first line while low risk patients were supposed to have plain films as a first line modality. The increase in percentage of patients receiving the correct first line modality was thought to be as a result of the newly instituted head and neck care bundle. Whilst this is an improvement, there were still 15 patients who were at high risk of c-spine fracture who did not receive the appropriate first line modality (CT) and therefore could have been missed.
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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 | 0.001 | 0.000 |
| 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 | 0.000 |
| Open science | 0.001 | 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".