Showing papers by "Ian McDowell published in 1994"
TL;DR: Implementation of the Ottawa ankle rules led to a decrease in use of ankle radiography, waiting times, and costs without patient dissatisfaction or missed fractures.
Abstract: Objective. —To assess the impact on clinical practice of implementing the Ottawa ankle rules. Design. —Nonrandomized, controlled trial with before-after and concurrent controls. Setting. —Emergency departments of a university (intervention) hospital and a community (control) hospital. Patients. —All 2342 adults seen with acute ankle injuries during 5-month periods before and after the intervention. Intervention. —The implementation of the Ottawa ankle rules by emergency department physicians. Main Outcome Measure. —Proportions of patients referred for standard ankle and foot radiographic series. Results. —There was a relative reduction in ankle radiography by 28% at the intervention hospital but an increase by 2% at the control hospital ( P P P P Conclusions. —Implementation of the Ottawa ankle rules led to a decrease in use of ankle radiography, waiting times, and costs without patient dissatisfaction or missed fractures. Future studies should address the generalizability of these decision rules in a variety of hospital settings. ( JAMA . 1994;271:827-832)
525 citations