%0 Journal Article %A Frank Coffey %A Susanne Hewitt %A Ian Stiell %A Nick Howarth %A Phil Miller %A Cathy Clement %A Paul Emberton %A Abdul Jabbar %T Validation of the Canadian c-spine rule in the UK emergency department setting %D 2011 %R 10.1136/emj.2009.089508 %J Emergency Medicine Journal %P 873-876 %V 28 %N 10 %X Aim To determine the potential of the Canadian Cervical Spine Rule (CCR) to safely reduce the number of cervical spine (c-spine) radiographs performed in the UK emergency department setting.Methods The study was conducted in two UK emergency departments with a combined annual attendance of >150 000 adult patients. Over the 24 month trial period, 148 doctors were provided training in the use of the CCR and instructed to assess eligible patients presenting with potential c-spine injury. Doctors were instructed to manage patients according to existing practice and not according to the decision obtained from the rule. A subsample of patients was reassessed by a second doctor to test interobserver reliability.Results A total of 1420 patients were enrolled in the study (50.4% male). 987 (69.5%) had c-spine radiography performed, with 8 (0.6%) having a c-spine injury. If the decision for radiography had been made according to the outcome of the CCR, only 815 (57.4%) would have had c-spine radiography and all 8 abnormal cases would have undergone imaging. Doctors were comfortable using the rule in 91% of cases. Interobserver reliability was good (κ=0.75 95% CI 0.44 to 1.06).Conclusion The CCR can be applied successfully in the UK. Had the CCR been in use during the study period, a 17.4% reduction in radiography could have been achieved without compromising patient care. %U https://emj.bmj.com/content/emermed/28/10/873.full.pdf