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Amsterdam Wrist Rules


- candidate number21738
- NTR NumberNTR5074
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR2-mrt-2015
- Secondary IDsW13_101 # 14.17.0327 
- Public TitleAmsterdam Wrist Rules
- Scientific TitleAmsterdam Wrist Rules, a Clinical Decision Rule
- ACRONYMAWR
- hypothesisWith implementation of the AWR we expect a reduction in the total amount of radiographs requested, without missing any clinical relevant fractures. We also expect a reduction in overall waiting times at the ED and a total amount of cost savings around 4 million euro's a year.
- Healt Condition(s) or Problem(s) studiedWrist fracture, Distal radius, Diagnostic work-up
- Inclusion criteriaAll consecutive adult patients presenting with acute wrist trauma at the Emergency Department.
- Exclusion criteria- The injury occurred more than 72 hours previous to the presentation at the Emergency Department
- Patients who sustained multiple injuries with an Injury Severity Score (ISS) more than 16
- Patients whose X-rays were requested previous to their visit to the Emergency Department (for example by their general practitioner)
- A wrist fracture in the past 3 months
- mec approval receivedyes
- multicenter trialyes
- randomisedno
- groupParallel
- TypeSingle arm
- Studytypeobservational
- planned startdate 1-dec-2014
- planned closingdate1-dec-2016
- Target number of participants377
- InterventionsNone.
- Primary outcomeThe number of requested X-rays in adult patients with acute injury of the wrist after implementation of the AWR.
- Secondary outcome- The number of clinically relevant missed fractures of the distal radius after implementation of the AWR
- The reduction of overall waiting time at the ED
- Cost-effectiveness of the AWR
- TimepointsOutcomes will be evaluated at the end of the inclusion period.
- Trial web sitewww.amsterdamwristrules.nl
- statusstopped: trial finished
- CONTACT FOR PUBLIC QUERIES Marjolein A.M. Mulders
- CONTACT for SCIENTIFIC QUERIES Niels W.L. Schep
- Sponsor/Initiator Academic Medical Center (AMC), Amsterdam
- Funding
(Source(s) of Monetary or Material Support)
ZON-MW, The Netherlands Organization for Health Research and Development
- PublicationsBentohami A, Walenkamp MMJ, Slaar A, Beerekamp MSH, de Groot JaH, Verhoog EM, et al. Amsterdam wrist rules: a clinical decision aid. BMC musculoskeletal disorders. 2011;12:238.
- Brief summaryAlmost every adult patient who sustained wrist trauma is referred for radiological examination to rule out a wrist fracture. However, around 50% of these X-rays do not show a fracture. The Amsterdam Wrist Rule is an externally validated clinical decision rule, based on clinical parameters, which helps determine the need for radiography in patients with wrist trauma. With this study we aim to evaluate the implementation of the Amsterdam Wrist Rules in the Emergency Department.
- Main changes (audit trail)
- RECORD2-mrt-2015 - 14-feb-2016


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