Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
In Reply: Given the current methodology of
clinical decision rule studies,1,2
we believe that Dr Lynch's concerns are minor limitations that offer no threats
to the internal or external validity of our study. Our derivation study had
neither the intent of validating nor of implementing a decision rule. Seventy-five
percent enrollment of eligible patients is quite superb for any clinical study,
particularly one in the busy setting of an emergency department. We fully
accounted for all patients in our analysis. Patients who could not be followed
up and who had no outcome measures were not included in the final analysis.
This derivation study generated hypotheses rather than tested them.
Stiell IG, Wells GA. Decisions About Cervical Spine Radiography Following Trauma—Reply. JAMA. 2002;287(5):583-584. doi:10.1001/jama.287.5.583