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The Ottawa ankle rules for the use of diagnostic X-ray in after hours medical centres in New Zealand

Wynn-Thomas, Simon; Love, Tom; McLeod, Deborah; Vernall, Sue; Kljakovic, Marjan; Dowell, Anthony; Durham, John

Description

Aims: The aims of this study were to measure baseline use of Ottawa ankle rules (OAR), validate the OAR and, if appropriate, explore the impact of implementing the Rules on X-ray rates in a primary care, after hours medical centre setting. Methods: General practitioners (GPs) were surveyed to find their awareness of ankle injury guidelines. Data concerning diagnosis and X-ray utilisation were collected prospectively for patients presenting with ankle injuries to two after hours...[Show more]

dc.contributor.authorWynn-Thomas, Simon
dc.contributor.authorLove, Tom
dc.contributor.authorMcLeod, Deborah
dc.contributor.authorVernall, Sue
dc.contributor.authorKljakovic, Marjan
dc.contributor.authorDowell, Anthony
dc.contributor.authorDurham, John
dc.date.accessioned2012-05-23T05:00:51Z
dc.date.available2012-05-23T05:00:51Z
dc.identifier.issn0028-8446
dc.identifier.issn1175-8716
dc.identifier.urihttp://hdl.handle.net/1885/9038
dc.description.abstractAims: The aims of this study were to measure baseline use of Ottawa ankle rules (OAR), validate the OAR and, if appropriate, explore the impact of implementing the Rules on X-ray rates in a primary care, after hours medical centre setting. Methods: General practitioners (GPs) were surveyed to find their awareness of ankle injury guidelines. Data concerning diagnosis and X-ray utilisation were collected prospectively for patients presenting with ankle injuries to two after hours medical centres. The OAR were applied retrospectively, and the sensitivity and specificity of the OAR were compared with GPs’ clinical judgement in ordering X-rays. The outcome measures were X-ray utilisation and diagnosis of fracture. Results: Awareness of the OAR was low. The sensitivity of the OAR for diagnosis of fractures was 100% (95% CI: 75.3 – 100) and the specificity was 47% (95% CI: 40.5 – 54.5). The sensitivity of GPs’ clinical judgement was 100% (95% CI: 75.3 – 100) and the specificity was 37% (95% CI: 30.2 – 44.2). Implementing the OAR would reduce X-ray utilisation by 16% (95% CI: approx 10.8 – 21.3). Conclusions: The OAR are valid in a New Zealand primary care setting. Further implementation of the rules would result in some reduction of X-rays ordered for ankle injuries, but less than the reduction found in previous studies.
dc.description.sponsorshipAccident Compensation Corporation of New Zealand
dc.description.sponsorshipOtago University
dc.format7 pages
dc.publisherNew Zealand Medical Association
dc.rightshttp://www.sherpa.ac.uk/romeo/issn/0028-8446 "... author cannot archive pre-print [or] ... post-print ... author can archive publisher's version/PDF ... 3 months after publication ... Publisher's version/PDF must be used. Publisher copyright and source must be acknowledged. Must link to publisher version ... " - from SHERPA/RoMEO site (as at 16/05/12)
dc.sourceNew Zealand Medical Journal 115.1162 (2002): 1-7
dc.source.urihttp://journal.nzma.org.nz/journal/115-1162/184/content.pdf
dc.titleThe Ottawa ankle rules for the use of diagnostic X-ray in after hours medical centres in New Zealand
dc.typeJournal article
local.description.notesThe study was funded by grants from Otago University and the Accident Compensation Corporation of New Zealand. At time of writing, M. Kljakovic was affiliated with University of Otago, Wellington School of Medicine and Health Sciences, General Practice Department
dc.date.issued2002-09-27
local.publisher.urlhttp://www.nzma.org.nz/
local.type.statusPublished Version
local.contributor.affiliationKljakovic, Marjan, ANU Medical School
local.contributor.affiliationWynn-Thomas, Simon, University of Otago, Wellington School of Medicine and Health Sciences, General Practice Department
local.contributor.affiliationLove, Tom, University of Otago, Wellington School of Medicine and Health Sciences, General Practice Department
local.contributor.affiliationMcLeod, Deborah, University of Otago, Wellington School of Medicine and Health Sciences, General Practice Department
local.contributor.affiliationVernall, Sue, University of Otago, Wellington School of Medicine and Health Sciences, General Practice Department
local.contributor.affiliationDowell, Antony, University of Otago, Wellington School of Medicine and Health Sciences, General Practice Department
local.contributor.affiliationDurham, John, University of Otago, Wellington School of Medicine and Health Sciences, General Practice Department
CollectionsANU Research Publications

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