Clinical decision rules for adults with minor head injury: a systematic review

Computed tomography (CT) of the head is the diagnostic standard for identifying intracranial injury. Routine CT of all minor head injury patients would result in a large number of normal CT scans being performed with associated risks of radiation exposure and waste of health care resources. Researchers have therefore attempted to derive clinical decision rules to identify those at risk of intracranial injury based on clinical characteristics at presentation in order to select them for imaging. It is currently unclear how existing rules compare in terms of diagnostic accuracy. This study aimed to systematically identify clinical decision rules for adults with minor head injury and compare the decision/prediction rules in terms of estimated diagnostic accuracy for any intracranial injury and injury requiring neurosurgery.