Head injury decision rules in children

Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study – The Lancet (link to abstract – $ for full-text)

Sources: External Validation of Three Decision Rules for Pediatric Head Injury – Journal Watch (free) AND Best way to diagnose head injuries in children and minimize CT scans – ScienceDaily (free) AND PECARN, CATCH, CHALICE … or None of the Above? – By Ryan P. Radecki, MD, in Emergency Medicine Literature of Note (free)

The 3 decision rules performed well with negative predictive values >99%. The PECARN clinical decision rule was more sensitive and missed only 1 patient with clinically important traumatic brain injury, but was less specific, meaning more CTs would be required. These findings indicate that CT can generally be avoided if one of the prediction rules are negative.