Cochrane · systematic review · CD011686
Triage tools for detecting cervical spine injury in paediatric trauma patients
Tavender, E, Eapen, N, Wang, J, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
Back and NeckAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
10
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 40%Low 2 · 20%Moderate 4 · 40%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Direct comparisons of clinical decision rules (CDRs) or sets of clinical criteria
Population: children (aged 0 to < 18 years) who underwent blunt trauma evaluation in the emergency department Index test: CDRs or sets of clinical criteria that compared the diagnostic accuracy of the test for cervical spine injury with the reference standard Comparator: studies comparing ≥ 2 CDRs (directly) Reference standard: X‐ray, CT, MRI or clinical clearance/follow‐up in low‐risk children Study types: diagnostic studies with cross‐sectional or cohort designs (retrospective or prospective) and randomised controlled trials
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Phillips 2021 | no estimate extracted | 973 participants | Moderate Downgraded: risk of bias |
Leonard 2019 | no estimate extracted | 4091 participants | Moderate Downgraded: risk of bias |
Davies 2016 | no estimate extracted | 270 participants | Very low Downgraded: risk of bias, indirectness |
Indirect comparisons of clinical decision rules (CDRs) or sets of clinical criteria
Population: children (aged 0 to < 18 years) who underwent blunt trauma evaluation in the emergency department Index test: CDRs that compared the diagnostic accuracy of the test for cervical spine injury with the reference standard Comparator: studies evaluating 1 single CDR or ≥ 2 CDRs (indirectly) Reference standard: X‐ray, CT, MRI or clinical clearance/follow‐up in low‐risk children Study types: diagnostic studies with cross‐sectional or cohort designs (retrospective or prospective) and randomised controlled trials
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
NEXUS | no estimate extracted | 2 studies · 4038 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Canadian C‐Spine Rule | no estimate extracted | 1 study · 973 participants | Moderate Downgraded: risk of bias |
PECARN retrospective | no estimate extracted | 2 studies · 5064 participants | Moderate Downgraded: risk of bias |
Leonard de novo | no estimate extracted | 1 study · 4091 participants | Low Downgraded: risk of bias, indirectness |
PEDSPINE criteria | no estimate extracted | 1 study · 12537 participants | Very low Downgraded: risk of bias, indirectness |
NICE CG56 | no estimate extracted | 1 study · 270 participants | Very low Downgraded: risk of bias, indirectness |
NICE CG176 | no estimate extracted | 1 study · 270 participants | Very low Downgraded: risk of bias, indirectness |