| Roberge RJ et al, 1988, USA | 467 blunt trauma patients undergoing c-spine radiograph | Prospective | Cervical spine injury | In alert patients cervical spine pain. Sensitivity 100% (54–100). Cervical spine tenderness, sensitivity 100% (54–100) | |
| Roberge RJ and Wears RC, 1992, USA | 480 blunt trauma patients undergoing c-spine radiograph | Prospective | Cervical spine injury | Clinical examination in alert patients, sensitivity 93% (75–100). Negative predictive value 98.7% (94.9–100) | Not all patients included |
| | | | | Total number of blunt trauma victims not known |
| | | | | No search for misses |
| Hoffman JR et al, 1992, USA | 974 blunt trauma patients who had radiograph performed and data sheet filled in | Prospective | Cervical spine fracture | Alert patient with no intoxication, midline neck tenderness or distracting injury, sensitivity=100% | Not all patients included in the study |
| | | | | No search for misses |
| Velhamos GC et al, 1996, USA | 549 blunt trauma patients | Prospective | Cervical spine injury or fracture | All patients had normal c-spine examination. No c-spine fractures or cord injuries found | |
| Alert, not intoxicated and no neck pain | | | | |
| Brought to hospital in hard collar | | | | |
| Gonzalez RP et al, 1999, USA | 2176 consecutive blunt trauma patients | Prospective | Cervical spine injury | Clinical examination 91% sensitivity for CSI; lateral c-spine screen (xr, swimmers CT) 61% sensitivity for CSI | Includes intoxicated patients |
| GCs 14 or 15 | | | | No power calculation |
| | | | | No search for misses |
| Hoffman JR et al, 2000, USA | 34069 patients having cervical spine radiograph after blunt trauma | Prospective | Clinically significant cervical spine injury | Decision instrument (alert with no evidence of intoxication, no midline cervical tenderness and no neurological deficit or distracting injury). Sensitivity of 99.6% (98.6–100) for significant injury, negative predictive value 99.9% (98.8–100) | |
| 21 centres | | | | |