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Canadian C-Spine Rule study for alert and stable trauma patients: I. Background and rationale

Published online by Cambridge University Press:  21 May 2015

Ian G. Stiell ,
George A. Wells ,
R. Douglas McKnight ,
Robert Brison ,
Howard Lesiuk ,
Catherine M. Clement ,
Mary A. Eisenhauer ,
Gary H. Greenberg ,
Iain MacPhail  and
Mark Reardon
...Show all authors
Ian G. Stiell*
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
George A. Wells
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
R. Douglas McKnight
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Robert Brison
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Howard Lesiuk
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Catherine M. Clement
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Mary A. Eisenhauer
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Gary H. Greenberg
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Iain MacPhail
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Mark Reardon
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
James Worthington
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Richard Verbeek
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Jonathan Dreyer
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Daniel Cass
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Michael Schull
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Laurie Morrison
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Brian Rowe
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Brian Holroyd
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Glen Bandiera
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
Andreas Laupacis
Affiliation:
Division of Emergency Medicine, Department of Medicine, Department of Epidemiology and Community Medicine, Division of Neurosurgery and the Clinical Epidemiology Unit of the University of Ottawa, Ottawa, Ont.; the Department of Emergency Medicine, Queen’s University, Kingston, Ont.; the Divisions of Emergency Medicine, University of Alberta, Edmonton, Alta.; the University of Toronto, Toronto, Ont.; the University of Western Ontario, London, Ont.; and the University of British Columbia, Vancouver, BC
*
Clinical Epidemiology Unit, F6, Ottawa Health Research Institute, 1053 Carling Ave., Ottawa ON K1Y 4E9; 613 798-5555 x18688, fax 613 761-5351, istiell@ohri.ca

Abstract

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This paper is Part I of a 2-part series to describe the background and methodology for the Canadian C-Spine Rule study to develop a clinical decision rule for rational imaging in alert and stable trauma patients. Current use of radiography is inefficient and variable, in part because there has been a lack of evidence-based guidelines to assist emergency physicians. Clinical decision rules are research-based decision-making tools that incorporate 3 or more variables from the history, physical examination or simple tests. The Canadian CT Head and C-Spine (CCC) Study is a large collaborative effort to develop clinical decision rules for the use of CT head in minor head injury and for the use of cervical spine radiography in alert and stable trauma victims. Part I details the background and rationale for the development of the Canadian C-Spine Rule. Part II will describe in detail the objectives and methods of the Canadian C-Spine Rule study.

Keywords

radiographycervical spine injuriesdecision rules
Type
State of the Art • Innovations
Information
Canadian Journal of Emergency Medicine , Volume 4 , Issue 2 , March 2002 , pp. 84 - 90
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

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