Clinical Decision Rule of Ungar et al for Excluding Thoracic Aortic Imaging Following Blunt Chest Trauma

Description

Ungar et al developed a clinical decision rule for excluding injury to the thoracic aorta following a motor vehicle collision with blunt chest trauma. This can reduce the need for performing imaging studies. The authors are from the University of Colorado in Denver.

Methodology: Classification and Regression Tree (CART)

Parameters seen in the initial chest radiograph:

(1) displacement of the left paraspinous line

(2) abnormal aortic knob (obscured)

(3) widened mediastinum

Displacement of the Left Paraspinous Line	Abnormal Aortic Knob (Obscurred)	Widened Mediastinum	Percent Traumatic Aortic Injury (Mean Value)
Yes	NA	NA	11%
No	Yes	Yes	5%
No	Yes	No	0%
No	No	NA	0.4%

Performance of the CART model:

• The sensitivity was 86% and the specificity is 77%.

• The negative predictive value is 99.6% (I am not sure how this was achieved with the reported sensitivity and specificity).

• The positive predictive value was 7%.

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Description

Specialty

ICD-10