{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T20:55:00Z","timestamp":1766609700388,"version":"3.40.4"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Ankle and midfoot injuries constitute one of the most frequent reasons to visit the pediatric emergency department (ED). The aims of the study were (1) to determine the feasibility of the Ottawa Ankle Rules (OARs) in a pediatric ED and its reliability to safely manage ankle and midfoot injuries and (2) to verify the impact in reducing the number of radiographs, healthcare costs, and time spent in the ED.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The prospective study enrolled 90 patients for the control group and 94 for the case group. For the control group, the standard of practice was registered. In the case group, before beginning enrolment, an instruction of how to apply the OARs were given to all clinicians. After that, OARs were applied according to patient complaints. A follow-up call was made for both groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The mean age of the control group was 11.9 years (standard deviation, 3.267 years), whereas in the case group was 11.3 years (standard deviation, 3.533 years). Demographic and injury characteristics were similar in both groups. A significant statistical difference was verified in the number of radiographs (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001) with a reduction of 16.7% in the case group. Patients who did not perform radiography, in the case group, spent at least 1 hour less than the ones who did. The OARs have shown a sensitivity of 100% (95% confidence interval, 39.76\u2013100.00) and specificity of 23.33% (95% CI, 15.06\u201333.43) with a negative predictive value of 100%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The OARs are an important clinical instrument with a high sensitivity and negative predictive value, which allows clinicians to avoid unnecessary exposure to radiation without missing clinically relevant fractures.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002528","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T00:06:20Z","timestamp":1631232380000},"page":"e1123-e1126","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Applying the Ottawa Ankle Rules in a Pediatric Emergency Department"],"prefix":"10.1097","volume":"38","author":[{"given":"Sara Isabel de","family":"Almeida","sequence":"first","affiliation":[]},{"given":"Joana","family":"Rios","sequence":"additional","affiliation":[]},{"given":"Sofia","family":"Costa Lima","sequence":"additional","affiliation":[]},{"given":"Paulo","family":"Oom","sequence":"additional","affiliation":[]}],"member":"276","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1097\/PEC.0000000000001197","article-title":"Is radiography necessary for pediatric emergency department clinicians to safely manage ankle injuries?","volume":"35","year":"2019","journal-title":"Pediatr Emerg Care"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/j.1553-2712.2010.00787.x","article-title":"Pediatric emergency physician opinions on ankle radiograph clinical decision rules","volume":"17","year":"2010","journal-title":"Acad Emerg Med"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1016\/S0140-6736(01)07218-X","article-title":"Sensitivity of a clinical examination to predict need for radiography in children with ankle injuries: a prospective study","volume":"358","year":"2001","journal-title":"Lancet"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1136\/bmj.326.7386.417","article-title":"Accuracy of Ottawa Ankle Rules to exclude fractures of the ankle and mid-foot: systematic review","volume":"326","year":"2003","journal-title":"BMJ"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/S0196-0644(05)82656-3","article-title":"A study to develop clinical decision rules for the use of radiography in acute ankle injuries","volume":"21","year":"1992","journal-title":"Ann Emerg Med"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1001\/jama.1993.03500090063034","article-title":"Decision rules for the use of radiography in acute ankle injuries. 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