Clinical decision rules in the emergency department.

© 2000 Canadian Medical Association or its licensors Clinical decision (or prediction) rules attempt to reduce the uncertainty of medical decision-making by standardizing the collection and interpretation of clinical data. A decision rule is derived from original research and may be defined as a decision-making tool that incorporates 3 or more variables from the history, physical examination or simple tests. My emergency department colleagues commonly see 2 clinical problems for which there is a strong need for decision rules: whether to order a computed tomography (CT) scan for patients with minor head injury and whether cervical spine radiography is required for alert and stable trauma patients. Two recently published papers propose decision rules for these problems. Should they be put into practice?