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A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): The Australasian Paediatric Head Injury Rules Study (APHIRST)

Oakley, Ed; Williams, Amanda; Crowe, Louise; Jachno, Kim; Donath, Susan; Neutze, Jocelyn; Gilhotra, Yuri; Cheek, John A.; Dalziel, Stuart R.; Lyttle, Mark D.; Ward, Brenton; Babl, Franz E.; Lyttle, Mark; Bressan, Silvia; Borland, Meredith; Phillips, Natalie; Kochar, Amit; Dalziel, Stuart R; Dalton, Sarah; Cheek, John; Furyk, Jeremy

A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): The Australasian Paediatric Head Injury Rules Study (APHIRST) Thumbnail


Authors

Ed Oakley

Amanda Williams

Louise Crowe

Kim Jachno

Susan Donath

Jocelyn Neutze

Yuri Gilhotra

John A. Cheek

Stuart R. Dalziel

Mark D. Lyttle

Brenton Ward

Franz E. Babl

Silvia Bressan

Meredith Borland

Natalie Phillips

Amit Kochar

Stuart R Dalziel

Sarah Dalton

John Cheek

Jeremy Furyk



Abstract

Background: Head injuries in children are responsible for a large number of emergency department visits. Failure to identify a clinically significant intracranial injury in a timely fashion may result in long term neurodisability and death. Whilst cranial computed tomography (CT) provides rapid and definitive identification of intracranial injuries, it is resource intensive and associated with radiation induced cancer. Evidence based head injury clinical decision rules have been derived to aid physicians in identifying patients at risk of having a clinically significant intracranial injury. Three rules have been identified as being of high quality and accuracy: the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) from Canada, the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE) from the UK, and the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury developed by the Pediatric Emergency Care Applied Research Network (PECARN) from the USA. This study aims to prospectively validate and compare the performance accuracy of these three clinical decision rules when applied outside the derivation setting.Methods/design: This study is a prospective observational study of children aged 0 to less than 18 years presenting to 10 emergency departments within the Paediatric Research in Emergency Departments International Collaborative (PREDICT) research network in Australia and New Zealand after head injuries of any severity. Predictor variables identified in CATCH, CHALICE and PECARN clinical decision rules will be collected. Patients will be managed as per the treating clinicians at the participating hospitals. All patients not undergoing cranial CT will receive a follow up call 14 to 90 days after the injury. Outcome data collected will include results of cranial CTs (if performed) and details of admission, intubation, neurosurgery and death. The performance accuracy of each of the rules will be assessed using rule specific outcomes and inclusion and exclusion criteria.Discussion: This study will allow the simultaneous comparative application and validation of three major paediatric head injury clinical decision rules outside their derivation setting.Trial registration: The study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR)- ACTRN12614000463673 (registered 2 May 2014). © 2014 Babl et al.; licensee BioMed Central Ltd.

Citation

Oakley, E., Williams, A., Crowe, L., Jachno, K., Donath, S., Neutze, J., …Furyk, J. (2014). A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): The Australasian Paediatric Head Injury Rules Study (APHIRST). BMC Pediatrics, 14(1), 148. https://doi.org/10.1186/1471-2431-14-148

Journal Article Type Article
Publication Date Jun 13, 2014
Publicly Available Date Jun 6, 2019
Journal BMC Pediatrics
Electronic ISSN 1471-2431
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 14
Issue 1
Pages 148
DOI https://doi.org/10.1186/1471-2431-14-148
Keywords head injury, clinical decision rule, computed tomography, validation
Public URL https://uwe-repository.worktribe.com/output/822944
Publisher URL http://dx.doi.org/10.1186/1471-2431-14-148

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