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The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma

Overview of attention for article published in BMC Musculoskeletal Disorders, December 2015
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (69th percentile)
  • Good Attention Score compared to outputs of the same age and source (66th percentile)

Mentioned by

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2 tweeters
facebook
6 Facebook pages
video
1 video uploader

Citations

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23 Dimensions

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78 Mendeley
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Title
The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma
Published in
BMC Musculoskeletal Disorders, December 2015
DOI 10.1186/s12891-015-0829-2
Pubmed ID
Authors

Monique M. J. Walenkamp, Abdelali Bentohami, Annelie Slaar, M. Suzan H. Beerekamp, Mario Maas, L. Cara Jager, Nico L. Sosef, Romuald van Velde, Jan M. Ultee, Ewout W. Steyerberg, J. Carel Goslings, Niels W. L. Schep

Abstract

Although only 39 % of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergency Department (ED) for radiography. This multicenter prospective study consisted of three components: (1) derivation of a clinical prediction model for detecting wrist fractures in patients following wrist trauma; (2) external validation of this model; and (3) design of a clinical decision rule. The study was conducted in the EDs of five Dutch hospitals: one academic hospital (derivation cohort) and four regional hospitals (external validation cohort). We included all adult patients with acute wrist trauma. The main outcome was fracture of the wrist (distal radius, distal ulna or carpal bones) diagnosed on conventional X-rays. A total of 882 patients were analyzed; 487 in the derivation cohort and 395 in the validation cohort. We derived a clinical prediction model with eight variables: age; sex, swelling of the wrist; swelling of the anatomical snuffbox, visible deformation; distal radius tender to palpation; pain on radial deviation and painful axial compression of the thumb. The Area Under the Curve at external validation of this model was 0.81 (95 % CI: 0.77-0.85). The sensitivity and specificity of the Amsterdam Wrist Rules (AWR) in the external validation cohort were 98 % (95 % CI: 95-99 %) and 21 % (95 % CI: 15 %-28). The negative predictive value was 90 % (95 % CI: 81-99 %). The Amsterdam Wrist Rules is a clinical prediction rule with a high sensitivity and negative predictive value for fractures of the wrist. Although external validation showed low specificity and 100 % sensitivity could not be achieved, the Amsterdam Wrist Rules can provide physicians in the Emergency Department with a useful screening tool to select patients with acute wrist trauma for radiography. The upcoming implementation study will further reveal the impact of the Amsterdam Wrist Rules on the anticipated reduction of X-rays requested, missed fractures, Emergency Department waiting times and health care costs. This study was registered in the Dutch Trial Registry, reference number NTR2544 on October 1(st), 2010.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 78 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 1%
Unknown 77 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 16 21%
Student > Ph. D. Student 13 17%
Student > Bachelor 9 12%
Student > Doctoral Student 7 9%
Other 6 8%
Other 16 21%
Unknown 11 14%
Readers by discipline Count As %
Medicine and Dentistry 37 47%
Nursing and Health Professions 10 13%
Psychology 3 4%
Arts and Humanities 2 3%
Business, Management and Accounting 2 3%
Other 9 12%
Unknown 15 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 July 2019.
All research outputs
#4,682,741
of 15,462,543 outputs
Outputs from BMC Musculoskeletal Disorders
#1,031
of 3,008 outputs
Outputs of similar age
#108,778
of 368,924 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#81
of 247 outputs
Altmetric has tracked 15,462,543 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 3,008 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.3. This one has gotten more attention than average, scoring higher than 64% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 368,924 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 247 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.