Auleley G R, Kerboull L, Durieux P, Cosquer M, Courpied J P, Ravaud P
Assistance Publique-Hôpitaux de Paris, France.
Ann Emerg Med. 1998 Jul;32(1):14-8. doi: 10.1016/s0196-0644(98)70093-9.
To validate the Ottawa ankle rules to predict fractures in a French clinical setting when they are used by physicians not involved in their development.
We used a prospective patient survey by emergency physicians in a surgical emergency department of a university teaching hospital of the Assistance Publique-Hôpitaux de Paris. The study group consisted of 416 consecutive patients aged 18 years and older who presented with acute ankle or midfoot injuries in the surgical ED during a 4-month period. Radiography was performed in each patient after clinical evaluation findings were recorded.
Forty-nine ankle and 22 midfoot fractures were diagnosed. The decision rules had a sensitivity of .98, a specificity of .45, and a negative predictive value of .99 in detecting ankle fractures, a sensitivity of 1.0, a specificity of .29, and a negative predictive value of 1.0 in detecting midfoot fractures. The rules failed to predict one avulsion fracture in the ankle group. Application of these rules by emergency physicians would have reduced ankle or midfoot radiography requests by 33%.
Use of the Ottawa ankle rules by French emergency physicians not involved in the rules' development resulted in 99% sensitivity and had a potential of reducing radiography requests by 33%.
在法国临床环境中，由未参与渥太华踝关节规则制定的医生使用该规则来预测骨折情况，以验证其有效性。
我们在巴黎公共救助医院集团一所大学教学医院的外科急诊科进行了一项由急诊医生开展的前瞻性患者调查。研究组由416例年龄在18岁及以上的连续患者组成，这些患者在4个月期间因急性踝关节或中足损伤就诊于外科急诊科。在记录临床评估结果后，对每位患者进行了X线检查。
共诊断出49例踝关节骨折和22例中足骨折。在检测踝关节骨折时，该决策规则的敏感度为0.98，特异度为0.45，阴性预测值为0.99；在检测中足骨折时，敏感度为1.0，特异度为0.29，阴性预测值为1.0。该规则未能预测踝关节组中的一例撕脱性骨折。急诊医生应用这些规则可减少33%的踝关节或中足X线检查申请。
未参与渥太华踝关节规则制定的法国急诊医生使用该规则的敏感度为99%，且有可能减少33%的X线检查申请。
