2008Emergency Medicine JournalOpen access

Can patients apply the Ottawa ankle rules to themselves?

Jules Blackham, Tamara Claridge, Jonathan Richard Benger

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Abstract

OBJECTIVE: To determine whether patients with an ankle injury obtained the same results as clinicians when applying the Ottawa ankle rules (a validated clinical decision rule) to themselves. METHODS: Patients aged >15 years presenting to an inner city emergency department within 48 h of an ankle injury were asked to assess their own injury using the Ottawa ankle rules. The results of their self-assessment were compared with those of a treating clinician. RESULTS: Poor interobserver agreement was found between patients and clinicians. CONCLUSIONS: Making the Ottawa ankle rule more widely available to the general public is unlikely to reduce healthcare demand. Indeed, given the apparently low specificity of the rule, demand could actually increase as a result.

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OBJECTIVE: To determine whether patients with an ankle injury obtained the same results as clinicians when applying the Ottawa ankle rules (a validated clinical decision rule) to themselves. METHODS: Patients aged >15 years presenting to an inner city emergency department within 48 h of an ankle injury were asked to assess their own injury using the Ottawa ankle rules. The results of their self-assessment were compared with those of a treating clinician. RESULTS: Poor interobserver agreement was found between patients and clinicians. CONCLUSIONS: Making the Ottawa ankle rule more widely available to the general public is unlikely to reduce healthcare demand. Indeed, given the apparently low specificity of the rule, demand could actually increase as a result.

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Available abstract

OBJECTIVE: To determine whether patients with an ankle injury obtained the same results as clinicians when applying the Ottawa ankle rules (a validated clinical decision rule) to themselves. METHODS: Patients aged >15 years presenting to an inner city emergency department within 48 h of an ankle injury were asked to assess their own injury using the Ottawa ankle rules. The results of their self-assessment were compared with those of a treating clinician. RESULTS: Poor interobserver agreement was found between patients and clinicians. CONCLUSIONS: Making the Ottawa ankle rule more widely available to the general public is unlikely to reduce healthcare demand. Indeed, given the apparently low specificity of the rule, demand could actually increase as a result.

Key concepts: Medicine, Ankle, Ankle injury, Emergency department, Clinical judgment, Physical therapy, Medical emergency, Surgery

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