Related Experiment Video

Updated: Feb 6, 2026

Studying Brain Function in Children Using Magnetoencephalography
08:00

Studying Brain Function in Children Using Magnetoencephalography

Published on: April 8, 2019

9.6K

Accuracy of NEXUS II head injury decision rule in children: a prospective PREDICT cohort study

Franz E Babl1,2,3, Ed Oakley1,2,3, Stuart R Dalziel4,5

  • 1Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.

Emergency Medicine Journal : EMJ
|August 22, 2018
PubMed

Insights

The National Emergency X-Radiography Utilisation Study II (NEXUS II) clinical decision rule (CDR) accurately identifies intracranial injury in children with head trauma. However, its widespread application may increase CT scans due to clinician accuracy.

Area of Science:

  • Emergency Medicine
  • Pediatric Traumatology
  • Radiology

Background:

  • The National Emergency X-Radiography Utilisation Study II (NEXUS II) clinical decision rule (CDR) aids in optimizing computed tomography (CT) use for pediatric head trauma.
  • External validation of the NEXUS II CDR in a large, diverse cohort is crucial for its clinical utility.

Purpose of the Study:

  • To externally validate the accuracy of the NEXUS II CDR in detecting clinically important intracranial injury (ICI) in children presenting with head trauma.
  • To compare the diagnostic accuracy of the NEXUS II CDR with clinician-based assessment without the rule.

Main Methods:

  • A prospective observational study involving over 20,000 pediatric patients (<18 years) with head trauma across 10 Australian/New Zealand emergency departments.
  • The study assessed the sensitivity and specificity of the NEXUS II CDR for identifying ICI, with a secondary analysis of clinician accuracy without the rule.

Main Results:

  • The NEXUS II CDR demonstrated high sensitivity (99.0%) for detecting ICI in the overall cohort.
  • Specificity for the NEXUS II CDR was 47.2%, with 49.4% of unimaged children meeting NEXUS II risk criteria.
  • Clinician accuracy without the rule showed 100.0% sensitivity and 92.0% specificity for ICI.

Conclusions:

  • The NEXUS II CDR exhibits high sensitivity for identifying ICI in pediatric head trauma, consistent with its derivation study.
  • The high proportion of unimaged patients positive for NEXUS II criteria may lead to increased CT utilization, despite high clinician accuracy.
Abstract

Keywords:
emergency departmentsimaging, ct/mripaediatrics, paediatric emergency medicinetrauma, head

More Related Videos

Gaze in Action: Head-mounted Eye Tracking of Children's Dynamic Visual Attention During Naturalistic Behavior07:09

Gaze in Action: Head-mounted Eye Tracking of Children's Dynamic Visual Attention During Naturalistic Behavior

Published on: November 14, 2018

11.5K
A Repetitive Concussive Head Injury Model in Mice05:42

A Repetitive Concussive Head Injury Model in Mice

Published on: October 12, 2016

12.5K

Related Concept Videos

Exceptions to the Octet Rule02:55

Exceptions to the Octet Rule

Many covalent molecules have central atoms that do not have eight electrons in their Lewis structures. These molecules fall into three categories:
37.7K
Uncertainty in Measurement: Accuracy and Precision03:37

Uncertainty in Measurement: Accuracy and Precision

Scientists typically make repeated measurements of a quantity to ensure the quality of their findings and to evaluate both the precision and the accuracy of their results. Measurements are said to be precise if they yield very similar results when repeated in the same manner. A measurement is considered accurate if it yields a result that is very close to the true or the accepted value. Precise values agree with each other; accurate values agree with a true value. 
102.4K
Improving Translational Accuracy02:07

Improving Translational Accuracy

Base complementarity between the three base pairs of mRNA codon and the tRNA anticodon is not a failsafe mechanism. Inaccuracies can range from a single mismatch to no correct base pairing at all. The free energy difference between the correct and nearly correct base pairs can be as small as 3 kcal/ mol. With complementarity being the only proofreading step, the estimated error frequency would be one wrong amino acid in every 100 amino acids incorporated. However, error frequencies observed in...
15.0K
Lewis Symbols and the Octet Rule02:36

Lewis Symbols and the Octet Rule

Chemical bonds are complex interactions between two or more atoms or ions, which reduce the potential energy of the molecule. Gilbert N. Lewis developed a model called the Lewis model that simplified the depiction of chemical bond formation and provided straightforward explanations for the chemical bonds seen in most common compounds.
81.1K
The Aufbau Principle and Hund's Rule03:02

The Aufbau Principle and Hund's Rule

To determine the electron configuration for any particular atom, we can build the structures in the order of atomic numbers. Beginning with hydrogen, and continuing across the periods of the periodic table, we add one proton at a time to the nucleus and one electron to the proper subshell until we have described the electron configurations of all the elements. This procedure is called the aufbau principle, from the German word aufbau (“to build up”). Each added electron occupies the...
73.0K
Decision Making01:20

Decision Making

Decision-making is a fundamental cognitive process that involves evaluating alternatives and selecting among them. This process can range from simple choices, such as deciding what to wear, to complex decisions, like choosing a major in college or a career path. The complexity of the decision often dictates the approach we use, which can be broadly categorized into two types: automatic and controlled decision-making.
Automatic decision-making is fast, intuitive, and relies on gut feelings...
994