Comparison of Cervical Spine Injury Clinical Prediction Rules for Children After Blunt Trauma

Which of 3 prospectively derived clinical cervical spine injury (CSI) prediction rules for radiologic imaging (Pediatric Emergency Care Applied Research Network CSI prediction rule [PECARN CSI rule], National Emergency X-Radiography Utilization Study [NEXUS], Canadian Cervical Spine [c-spine] rule [CCR]) has the best test characteristics?In this comparative effectiveness study of the performance of CSI prediction rules in a cohort of 22 430 children, the PECARN CSI rule had the best test characteristics and lowest projected CT imaging rate.The PECARN CSI rule had the best test characteristics for risk stratifying children with potential CSI after blunt trauma who require cervical spine imaging.

Corresponding Author: Lois K. Lee, MD, MPH, Division of Emergency Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 (lois.lee@childrens.harvard.edu).

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