Clinical Decision Rules Essay

Clinical Decision Rules are a set of guidelines for clinicians to evaluate the need for radiographs avoiding unnecessary radiation exposure and ruling out the possibility of fracture. It is important to mention that before Clinical Decision Rules were established most patients were exposed to radiographs many of them getting negative reports and costing unneeded time and money. In addition of those three important Clinical Decision Rules ‘benefits, we cannot forget the opportunity provided by them for consistency in care. I intend to discuss the Clinical Decision Rules for the knee/ankle/foot applicable to the pediatric population.
The Ottawa Rules were published in 1992. There are the Ottawa Knee Rules and the Ottawa Ankle and Foot Rules. The Ottawa Knee Rules are very useful for patients with an acute knee injury. Although these rules were generated for patients under 18 y/o, these guidelines have been validated in

They are typically applicable to patients six years old and older showing a 98.5 average sensitivity for that population and exhibiting a very low rate of false negatives. The specificity is moderate: 40%. The OAR has been recognize to reduce the use of x-rays up to 30%. Please note some studies support the use of the OAR for patients as young as 2 y/o (Plint, Bulloch, Osmond, Stiell, Dunlap, Redd, Tenenbein, Klassen, 1999).
The Pittsburg Knee Rules is another series of rules to determine if the knee injury requires radiographs despite of the patients’ ages (McKinnis, 2014). Patients with a blunt/non-penetrating trauma of the knee can benefit of using the Pittsburg Knee Rules. The PKR has a sensitivity of 99%, a specificity of 60% increasing the opportunities to get a specific medical diagnosis, and reducing the need for x-rays by 52%. Comparing the PKR with the OKR, the literature states the PKR offer less false