title: Thoracic Injury Rule out Criteria in Prediction of Traumatic Intra-thoracic Injuries; a Validation Study.
abstract: BACKGROUND
  Doing Chest X Ray (CXR) for all trauma patients is not efficient and cost effective due to its low diagnostic value. The present study was designed aiming to evaluate the diagnostic accuracy of thoracic injury rule out criteria (TIRC) in prediction of traumatic intra-thoracic injuries and need for CXR.
  
  
  METHODS
  The present study is a prospective cross-sectional study that has been carried out to evaluate the accuracy of TIRC model in screening blunt multiple trauma patients in need of CXR for ruling out intra-thoracic injuries.
  
  
  RESULTS
  1518 patients with the mean age of 33.53 ± 15.42 years were enrolled (80.4% male). The most common mechanisms of trauma were motor car accident (78.8%) and falling (13.6%). Area under the ROC curve, sensitivity, and specificity of model in detection of traumatic thoracic injuries was 0.95 (95% CI: 0.93 - 0.97), 100 (95% CI: 87.0 - 100), and 80.1 (95% CI: 78.0 - 82.1), respectively. Brier score for TIRC was 0.02 and its scaled reliability was 0.0002.
  
  
  CONCLUSIONS
  Findings of the present study showed that TIRC has high accuracy in prediction of traumatic intra-thoracic injuries and screening patients in need of CXR.
authors.affiliation: Clinical Research Development Center, Amir-Almomenin Hospital, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran.
authors.forename: Setareh
authors.initials: S
authors.lastname: Asgarzadeh
authors.affiliation: Emergency Department, Pasteur Hospital, Bam University of Medical Sciences, Bam, Iran.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Feizi
authors.affiliation: Clinical Research Development Center, Amir-Almomenin Hospital, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Sarabandi
authors.affiliation: Harvard T.H. Chan School of Public Health, 667 Huntington Avenue, Boston, MA, 02115.
authors.forename: Morteza
authors.initials: M
authors.lastname: Asgarzadeh
keywords: Thoracic injuries. decision support techniques; diagnosis; mass chest x-ray