STUDY OBJECTIVE: To determine the interrater reliability of previously defined risk criteria for cervical spine injury. METHODS: Two emergency physicians independently evaluated patients with blunt trauma to determine whether they exhibited any of four risk criteria: (1) altered neurologic function; (2) evidence of intoxication; (3) spinous process or posterior midline cervical tenderness; or (4) distracting painful injury. Each criterion was explicitly described on study data forms. Physician concordance was measured, and the kappa statistic was calculated, for the combined risk criteria (based on the presence of any individual criterion), and for each individual criterion. RESULTS: There were 122 patients evaluated. Physicians agreed on overall classifications for 107 patients (87.7%; kappa, .73; confidence interval [CI], .61 to .86). Agreement for individual criteria were as follows: (1) altered neurologic function--102 patients (83.6%; kappa, .58; CI, .41 to .74); (2) intoxication--118 patients (96.7%; kappa, .86; CI, .72 to .99); (3) posterior midline tenderness--109 patients (89.3%; kappa, .77; CI .65 to .89); (4) distracting injury--112 patients (91.8%; kappa.77; CI, .64 to .91). CONCLUSION: The combined cervical spine injury criteria have substantial interrater reliability. Individual criteria are slightly less reliable.
STUDY OBJECTIVE: To determine the interrater reliability of previously defined risk criteria for cervical spine injury. METHODS: Two emergency physicians independently evaluated patients with blunt trauma to determine whether they exhibited any of four risk criteria: (1) altered neurologic function; (2) evidence of intoxication; (3) spinous process or posterior midline cervical tenderness; or (4) distracting painful injury. Each criterion was explicitly described on study data forms. Physician concordance was measured, and the kappa statistic was calculated, for the combined risk criteria (based on the presence of any individual criterion), and for each individual criterion. RESULTS: There were 122 patients evaluated. Physicians agreed on overall classifications for 107 patients (87.7%; kappa, .73; confidence interval [CI], .61 to .86). Agreement for individual criteria were as follows: (1) altered neurologic function--102 patients (83.6%; kappa, .58; CI, .41 to .74); (2) intoxication--118 patients (96.7%; kappa, .86; CI, .72 to .99); (3) posterior midline tenderness--109 patients (89.3%; kappa, .77; CI .65 to .89); (4) distracting injury--112 patients (91.8%; kappa.77; CI, .64 to .91). CONCLUSION: The combined cervical spine injury criteria have substantial interrater reliability. Individual criteria are slightly less reliable.
Authors: Julie C Leonard; Lorin R Browne; Fahd A Ahmad; Hamilton Schwartz; Michael Wallendorf; Jeffrey R Leonard; E Brooke Lerner; Nathan Kuppermann Journal: Pediatrics Date: 2019-07 Impact factor: 7.124
Authors: William Ngatchou; Jeanne Beirnaert; Daniel Lemogoum; Cyril Bouland; Pierre Youatou; Ahmed Sabry Ramadan; Regis Sontou; Maimouna Bol Alima; Alain Plumaker; Virginie Guimfacq; Claude Bika; Pierre Mols Journal: Pan Afr Med J Date: 2018-06-21