{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T19:58:19Z","timestamp":1696276699445},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,4,23]],"date-time":"2013-04-23T00:00:00Z","timestamp":1366675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although uncommon, closed cervical fractures (<jats:styled-content style=\"fixed-case\">CCFs<\/jats:styled-content>) may present in orthopedic clinical settings despite previous workup. The objective of this study was to describe the characteristics associated with missed <jats:styled-content style=\"fixed-case\">CCF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was a retrospective database exploration of a cohort of subjects within a department of surgery with cervical pain. The sample consisted of 162 patients seen for a surgical consult for a number of cervical conditions. The examination time frame represented a clinical examination and imaging confirmation of diagnosis after an original initial visit by another provider. Descriptive and diagnostic accuracy values including sensitivity\/specificity and positive\/negative likelihood ratios (<jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>+\/<jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>\u2212) were calculated for each targeted variable. Clustered analyses were calculated using the patient history and situational characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven patients in the sample were diagnosed with <jats:styled-content style=\"fixed-case\">CCF<\/jats:styled-content> (6.7%). Six variables were significantly associated with a missed <jats:styled-content style=\"fixed-case\">CCF<\/jats:styled-content>. Using these six variables, it was found that failure to exhibit a condition of 2 of the 6 variables (1 or fewer) was the strongest in ruling out the condition (<jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>\u2212\u00a0=\u00a00.0; post\u2010test probability with a negative finding\u00a0=\u00a00%), whereas a finding of 4 of 6 was the most diagnostic for ruling in the condition (<jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>+\u00a0=\u00a032; post\u2010test probability with a positive finding\u00a0=\u00a070%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The findings in this sample suggest that select patient history or situational factors are still useful even after initial examination and clinicians must stay vigilant because <jats:styled-content style=\"fixed-case\">CCF<\/jats:styled-content>s may be missed during emergent care screens.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12061","type":"journal-article","created":{"date-parts":[[2013,4,24]],"date-time":"2013-04-24T03:23:32Z","timestamp":1366773812000},"page":"109-116","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Identifiers for Detecting Underlying Closed Cervical Fractures"],"prefix":"10.1111","volume":"14","author":[{"given":"Chad E.","family":"Cook","sequence":"first","affiliation":[{"name":"Division of Physical Therapy Walsh University North Canton Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip S.","family":"Sizer","sequence":"additional","affiliation":[{"name":"Doctor of Science Program in Physical Therapy Texas Tech University Lubbock Texas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Isaacs","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery Duke University Durham North Carolina 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