0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Predicting Intracranial Traumatic Findings on Computed Tomography in Patients with Minor Head Injury: The CHIP Prediction Rule

Marion Smits, MD; Diederik W.J. Dippel, MD, PhD; Ewout W. Steyerberg, MD, PhD; Gijs G. de Haan, MD; Helena M. Dekker, MD; Pieter E. Vos, MD, PhD; Digna R. Kool, MD; Paul J. Nederkoorn, MD, PhD; Paul A.M. Hofman, MD, PhD; Albert Twijnstra, MD, PhD; Hervé L.J. Tanghe, MD; and M.G. Myriam Hunink, MD, PhD
[+] Article and Author Information

From Erasmus MC–University Medical Center Rotterdam, Rotterdam, the Netherlands; University Medical Center Nijmegen St. Radboud, Nijmegen, the Netherlands; Academic Medical Center, Amsterdam, the Netherlands; and University Hospital Maastricht, Maastricht, the Netherlands.


Acknowledgments: The authors thank Mrs. J. Brauer, research nurse at the Department of Neurology at University Medical Center Nijmegen, St. Radboud; the research nurses at the Department of Radiology at Erasmus MC–Medical Center Rotterdam, Mrs. W.J. van Leeuwen, Mrs. C.H. van Bavel-van Hamburg, and Mrs. B. Tara-Prins, for their invaluable contribution to patient data collection; and Mr. P.I.R. Hilton for developing the online version of the CHIP prediction rule.

Grant Support: By College voor Zorgverzekeringen (CVZ) (VAZ 01-104) and Radiologisch onderzoek Nederland (RADION).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: M.G. Myriam Hunink, MD, PhD, Department of Epidemiology and Biostatistics and Department of Radiology, Erasmus MC–University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands; e-mail, m.hunink@erasmusmc.nl.

Current Author Addresses: Drs. Smits and Tanghe: Department of Radiology, Erasmus MC–University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.

Dr. Dippel: Department of Neurology, Erasmus MC–University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.

Dr. Steyerberg: Department of Public Health, Erasmus MC–University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.

Dr. de Haan: Department of Medical Informatics, Erasmus MC–University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.

Drs. Dekker and Kool: Department of Radiology, University Medical Center Nymeger, St. Radboud, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands.

Dr. Vos: Department of Neurology, University Medical Center Nymeger, St. Radboud, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands.

Dr. Nederkoorn: Department of Neurology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.

Dr. Hofman: Department of Radiology, University Hospital Maastricht, PO Box 5800, 6200 AZ Maastricht, the Netherlands.

Dr. Twijnstra: Department of Neurology, University Hospital Maastricht, PO Box 5800, 6200 AZ Maastricht, the Netherlands.

Dr. Hunink: Department of Epidemiology and Biostatistics and Department of Radiology, Erasmus MC–University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.

Author Contributions: Conception and design: M. Smits, D.W.J. Dippel, M.G.M. Hunink.

Analysis and interpretation of the data: M. Smits, D.W.J. Dippel, E.W. Steyerberg, M.G.M. Hunink.

Drafting of the article: M. Smits, D.W.J. Dippel, M.G.M. Hunink.

Critical revision of the article for important intellectual content: M. Smits, D.W.J. Dippel, E.W. Steyerberg, G.G. de Haan, H.M. Dekker, P.E. Vos, D.R. Kool, P.J. Nederkoorn, P.A.M. Hofman, A. Twijnstra, H.L.J. Tanghe, M.G.M. Hunink.

Final approval of the article: M. Smits, D.W.J. Dippel, E.W. Steyerberg, G.G. de Haan, H.M. Dekker, P.E. Vos, D.R. Kool, P.J. Nederkoorn, P.A.M. Hofman, A. Twijnstra, H.L.J. Tanghe, M.G.M. Hunink.

Provision of study materials or patients: D.W.J. Dippel, H.M. Dekker, P.E. Vos, D.R. Kool, P.J. Nederkoorn, P.A.M. Hofman, A. Twijnstra, H.L.J. Tanghe.

Statistical expertise: E.W. Steyerberg.

Obtaining of funding: M.G.M. Hunink.

Administrative, technical, or logistic support: M. Smits, D.W.J. Dippel, G.G. de Haan, H.M. Dekker, P.E. Vos, D.R. Kool, P.J. Nederkoorn, P.A.M. Hofman, A. Twijnstra, H.L.J. Tanghe, M.G.M. Hunink.

Collection and assembly of data: M. Smits, D.W.J. Dippel, H.M. Dekker, P.E. Vos, D.R. Kool, P.J. Nederkoorn, P.A.M. Hofman, A. Twijnstra.


Ann Intern Med. 2007;146(6):397-405. doi:10.7326/0003-4819-146-6-200703200-00004
Text Size: A A A

Between 11 February 2002 and 31 August 2004, an estimated 6936 patients with head injury presented to the emergency departments of the participating centers. We did not include 3572 of these patients because they did not meet the inclusion criteria. Of the 3364 patients originally included in the study, we excluded 183 from further analysis for various reasons (Figure 1), leaving 3181 patients for the data analysis.

First Page Preview

View Large
First page PDF preview

Figures

Grahic Jump Location
Figure 1.
Study flow diagram.

The number of patients presenting with head injury is an estimate based on the proportion of patients included out of the total number of trauma patients seen by a neurologist or neurologist-in-training in the emergency department of the participating center that included most patients. CT = computed tomography.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Receiver-operating characteristic curves of the detailed prediction model.

The dashed line represents the receiver-operating characteristic (ROC) curve for neurosurgical interventions (area under the curve, 0.85 [95% CI, 0.76 to 0.94]), and the solid line represents the ROC curve for intracranial traumatic CT findings (area under the curve, 0.80 [95% CI, 0.77 to 0.83]).

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Predicting Intracranial Traumatic Findings on Computed Tomography in Patients with Minor Head Injury: The CHIP Prediction Rule

The summary below is from the full report titled “Predicting Intracranial Traumatic Findings on Computed Tomography in Patients with Minor Head Injury: The CHIP Prediction Rule.” It is in the 20 March 2007 issue of Annals of Internal Medicine (volume 146, pages 397-405). The authors are M. Smits, D.W.J. Dippel, E.W. Steyerberg, G.G. de Haan, H.M. Dekker, P.E. Vos, D.R. Kool, P.J. Nederkoorn, P.A.M. Hofman, A. Twijnstra, H.L.J. Tanghe, and M.G.M. Hunink.

Read More...

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)