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The Amsterdam Paediatric Wrist Rules


- candidate number21817
- NTR NumberNTR5105
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR18-mrt-2015
- Secondary IDsW13_101 14.17.0327
- Public TitleThe Amsterdam Paediatric Wrist Rules
- Scientific TitleThe Amsterdam Paediatric Wrist Rules, An Implementation Study
- ACRONYMAPWR
- hypothesisWith implementation of the APWR 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 3 million euro's a year.
- Healt Condition(s) or Problem(s) studiedWrist fracture, Distal radius, Diagnostic work-up, Children
- Inclusion criteriaAll patients from 3 till 18 years 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-apr-2015
- planned closingdate1-apr-2017
- Target number of participants377
- InterventionsX-ray of the wrist or not.
- Primary outcomeThe number of requested X-rays in children with acute injury of the wrist after implementation of the AWR.
- Secondary outcome- The number of clinically relevant missed fractures of the distal radius and distal ulna in children 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
- statusinclusion stopped: follow-up
- CONTACT FOR PUBLIC QUERIESMD 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)
Innovatiefonds zorgverzekeraars
- Publications
- Brief summaryAlmost every child who sustains 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 Paediatric Wrist Rule is an externally validated clinical decision rule, based on clinical parameters, which helps determine the need for radiography in children with wrist trauma. With this study we aim to evaluate the implementation of the Amsterdam Paediatric Wrist Rules in the Emergency Department.
- Main changes (audit trail)
- RECORD18-mrt-2015 - 30-jul-2017


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