{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T15:53:52Z","timestamp":1780588432470,"version":"3.54.1"},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Prediction rules for computed tomography (CT) use in mild traumatic brain injury (MTBI) often have limited generalizability due to restrictive inclusion criteria and development in high-income countries. A clinical-based prediction score was recently developed for a broader MTBI population in a low- to middle-income country. This study aims to externally validate this score in a new patient dataset.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We prospectively collected data from adult patients with MTBI (Glasgow Coma Scale score 13\u201315) presenting to a hospital in Thailand between 2014 and 2016. The performance of the 13-predictor clinical-based score was evaluated for two outcomes: traumatic intracranial findings on CT and need for neurosurgical intervention. We assessed discrimination using the area under the receiver operating characteristic curve (AuROC) and diagnostic accuracy at predetermined cut-points.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The study included 565 patients. Seventy-two patients (12.7%) had a positive CT scan, and 8 (1.4%) required neurosurgical intervention. The AuROC was 0.70 for predicting a positive CT scan and 0.78 for predicting neurosurgical intervention. At a cut-point score of \u22652, the sensitivity for a positive CT was 97.2% with a specificity of 12.6%. At a cut-point score of \u22653, the sensitivity for neurosurgical intervention was 100% with a specificity of 21.0%.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The clinical prediction score demonstrated acceptable and safe diagnostic performance in an external validation cohort, maintaining high sensitivity for critical outcomes. The score may be a useful tool to help guide management policy for MTBI patients, particularly in low- to middle-income countries.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_763_2024","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T15:13:00Z","timestamp":1767971580000},"page":"8","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An external validation of clinical-based score to predict traumatic intracranial hemorrhage on computed tomography scan and surgical intervention in mild traumatic brain injury patients"],"prefix":"10.25259","volume":"17","author":[{"given":"Tanat","family":"Vaniyapong","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthon","family":"Patumanond","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Clinical Statistics Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanguansin","family":"Ratanalert","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kriengsak","family":"Limpastan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"10.25259\/SNI_763_2024\/ref-1","doi-asserted-by":"crossref","first-page":"k3527","DOI":"10.1136\/bmj.k3527","article-title":"External validation of computed tomography decision rules for minor head injury: Prospective, multicentre cohort study in the Netherlands","volume":"362","author":"Foks","year":"2018","journal-title":"BMJ"},{"key":"10.25259\/SNI_763_2024\/ref-2","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/S0140-6736(01)06140-2","article-title":"The Canadian CT head rule","volume":"358","author":"Haydel","year":"2001","journal-title":"Lancet"},{"key":"10.25259\/SNI_763_2024\/ref-3","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1056\/NEJM200007133430204","article-title":"Indications for computed tomography in patients with minor head injury","volume":"343","author":"Haydel","year":"2000","journal-title":"N Engl J Med"},{"key":"10.25259\/SNI_763_2024\/ref-4","first-page":"1","article-title":"Clinical practice guidelines for traumatic brain injury","author":"Royal College of Thai Neurosurgeon","year":"2013","journal-title":"Tana Press"},{"key":"10.25259\/SNI_763_2024\/ref-5","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1001\/jama.294.12.1519","article-title":"External validation of the Canadian CT head rule and the new Orleans criteria for CT scanning in patients with minor head injury","volume":"294","author":"Smits","year":"2005","journal-title":"JAMA"},{"key":"10.25259\/SNI_763_2024\/ref-6","doi-asserted-by":"crossref","first-page":"397","DOI":"10.7326\/0003-4819-146-6-200703200-00004","article-title":"Predicting intracranial traumatic findings on computed tomography in patients with minor head injury: The CHIP prediction rule","volume":"146","author":"Smits","year":"2007","journal-title":"Ann Intern Med"},{"key":"10.25259\/SNI_763_2024\/ref-7","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1001\/jama.294.12.1511","article-title":"Comparison of the Canadian CT head rule and the New Orleans criteria in patients with minor head injury","volume":"294","author":"Stiell","year":"2005","journal-title":"JAMA"},{"key":"10.25259\/SNI_763_2024\/ref-8","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0140-6736(00)04561-X","article-title":"The Canadian CT Head Rule for patients with minor head injury","volume":"357","author":"Stiell","year":"2001","journal-title":"Lancet"},{"key":"10.25259\/SNI_763_2024\/ref-9","doi-asserted-by":"crossref","first-page":"2979","DOI":"10.1016\/j.injury.2022.07.001","article-title":"Update of the CHIP (CT in Head Injury Patients) decision rule for patients with minor head injury based on a multicenter consecutive case series","volume":"53","author":"Van Den Brand","year":"2022","journal-title":"Injury"},{"key":"10.25259\/SNI_763_2024\/ref-10","doi-asserted-by":"crossref","first-page":"64","DOI":"10.25259\/SNI-101-2019","article-title":"Clinical indicators for traumatic intracranial findings in mild traumatic brain injury patients","volume":"10","author":"Vaniyapong","year":"2019","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_763_2024\/ref-11","doi-asserted-by":"crossref","first-page":"e0239082","DOI":"10.1371\/journal.pone.0239082","article-title":"Development of clinical decision rules for traumatic intracranial injuries in patients with mild traumatic brain injury in a developing country","volume":"15","author":"Vaniyapong","year":"2020","journal-title":"PLoS One"},{"key":"10.25259\/SNI_763_2024\/ref-12","doi-asserted-by":"crossref","first-page":"5385613","DOI":"10.1155\/2017\/5385613","article-title":"Clinical factors predictive for intracranial hemorrhage in mild head injury","volume":"2017","author":"Yuksen","year":"2017","journal-title":"Neurol Res Int"}],"container-title":["Surgical Neurology 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