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Clinical prediction guide
The Canadian CT Head Rule reduced the need for CT scans more than the New Orleans Criteria in minor head injury

http://dx.doi.org/10.1136/ebm.11.2.61

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    Smits M, Dippel DW, de Haan GG, et al. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA 2005;294:1519–25.
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 Q In patients with minor head injury, how do the Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC) compare for selecting which patients should receive computed tomography (CT) scanning?

    Clinical impact ratings Emergency medicine ★★★★★★☆ Surgery—neurosurgery ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    external validation of 2 previously developed clinical prediction guides (CCHR and NOC).

    Embedded ImageSetting:

    4 university hospitals in the Netherlands.

    Embedded ImagePatients:

    3181 patients ⩾16 years of age (mean age 41 y, 71% men) who presented within 24 hours after blunt head injury and had a Glasgow Coma Scale (GCS) score of 13–14 or 15 with 1 of the following: history of loss of consciousness, short term memory deficit, amnesia for the traumatic event, post-traumatic seizure, vomiting, severe headache, intoxication with alcohol or drugs, use of anticoagulants or history of coagulopathy, injury above the clavicles, or neurological deficit. Patients who could not receive a CT scan because of concurrent injury …

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    Footnotes

    • For correspondence: Dr M G M Hunink, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands. m.hunink{at}erasmusmc.nl

    • Source of funding: College voor Zorgverzekeringen.