Diagnostic Accuracy of Ottawa Knee Rule for Diagnosis of Fracture in Patients with Knee Trauma, a Systematic Review and Meta-analysis

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KAZEMI SEYYED MORTEZA; Khorram Roya; Fayyazi shishavan Ehsan; Amani Beni Reza; Haririan Yas; HOSSEINI KHAMENEH SEYED MEHDI; Rahmani Erfan; Minaei Noshahr Reza; Sarikhani Mahshad; Rahimi Rana; SAEIDI SARA; Saeidi Diba; FARROKHI MEHRDAD

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Journal: Archives of Academic Emergency Medicine Year:621 | Volume: | Issue: Page(s): 0-0

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Title

Diagnostic Accuracy of Ottawa Knee Rule for Diagnosis of Fracture in Patients with Knee Trauma, a Systematic Review and Meta-analysis

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Keywords

Clinical decision rules

Knee injuries

Radiography

Abstract

Introduction: In order to improve the efficacy of requesting knee Radiography and reduce unnecessary radiation exposure, some Clinical decision rules have been proposed for the assessment of Knee injuries. Among them, theOttawa Knee Rule (OKR) was considered as one of the best guidelines with several validation studies. Therefore, in thismeta-analysis, we aimed to investigate the accuracy of OKR for diagnosis of fracture in patients presenting with knee trauma. Methods: A systematic search was conducted in PubMed, Web of Science, Scopus, Google Scholar, and EBSCO from inception to September 2022. Quality assessment of the included studies was performed using QUADAS-2 tool. Diagnostic accuracy parameters were analyzed using random-effects model. Statistical analysis was performed using Meta-Disc and Stata softwares. Results: The meta-analysis of the 18 included studies (6702 patients) showed that the pooled sensitivity and specificity of OKR for diagnosis of fractures were 0. 98 (95% CI: 0. 96-0. 99) and 0. 43 (95% CI: 0. 42-0. 45), respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 1. 56 (95% CI: 1. 39-1. 75) and 0. 12 (95% CI: 0. 05-0. 26), respectively. The area under curve (AUC) of the hierarchical summary receiver operating characteristic (HSROC) curve was 0. 54. Conclusion: This meta-analysis indicates that OKR has a high diagnostic performance for diagnosis of fracture, with a pooled sensitivity of 98% and a pooled specificity of 43%. These results propose potential effects of OKR on reduction of unnecessary Radiography, time spent in emergency departments, and direct and indirect costs, which should be confirmed using high-quality studies in the future.

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APA: Copy

KAZEMI, SEYYED MORTEZA, Khorram, Roya, Fayyazi shishavan, Ehsan, Amani Beni, Reza, Haririan, Yas, HOSSEINI KHAMENEH, SEYED MEHDI, Rahmani, Erfan, Minaei Noshahr, Reza, Sarikhani, Mahshad, Rahimi, Rana, SAEIDI, SARA, Saeidi, Diba, & FARROKHI, MEHRDAD. (2023). Diagnostic Accuracy of Ottawa Knee Rule for Diagnosis of Fracture in Patients with Knee Trauma, a Systematic Review and Meta-analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), 11(1), 0-0. SID. https://sid.ir/paper/1115147/en

Vancouver: Copy

KAZEMI SEYYED MORTEZA, Khorram Roya, Fayyazi shishavan Ehsan, Amani Beni Reza, Haririan Yas, HOSSEINI KHAMENEH SEYED MEHDI, Rahmani Erfan, Minaei Noshahr Reza, Sarikhani Mahshad, Rahimi Rana, SAEIDI SARA, Saeidi Diba, FARROKHI MEHRDAD. Diagnostic Accuracy of Ottawa Knee Rule for Diagnosis of Fracture in Patients with Knee Trauma, a Systematic Review and Meta-analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY)[Internet]. 2023;11(1):0-0. Available from: https://sid.ir/paper/1115147/en

IEEE: Copy

SEYYED MORTEZA KAZEMI, Roya Khorram, Ehsan Fayyazi shishavan, Reza Amani Beni, Yas Haririan, SEYED MEHDI HOSSEINI KHAMENEH, Erfan Rahmani, Reza Minaei Noshahr, Mahshad Sarikhani, Rana Rahimi, SARA SAEIDI, Diba Saeidi, and MEHRDAD FARROKHI, “Diagnostic Accuracy of Ottawa Knee Rule for Diagnosis of Fracture in Patients with Knee Trauma, a Systematic Review and Meta-analysis,” ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), vol. 11, no. 1, pp. 0–0, 2023, [Online]. Available: https://sid.ir/paper/1115147/en

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