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This Week in JAMA
October 17, 2001

This Week in JAMA

JAMA. 2001;286(15):1803. doi:10.1001/jama.286.15.1803

Indications for cervical spine (C-spine) radiography in stable and alert patients who have sustained blunt trauma to the head or neck are controversial, and current clinical practice regarding the use of C-spine radiography is highly variable. Based on the assessment of 8924 trauma patients, Stiell and colleaguesArticle derived a highly sensitive 3-question clinical decision rule for the use of C-spine radiography in alert and stable trauma patients at risk for neck injury. In an editorial, DaffnerArticle notes that this clinical decision rule should help improve identification of trauma patients who can be managed without radiography.

Newer and more expensive second-line antibiotics are often prescribed for the treatment of acute sinusitis. In this retrospective study using a pharmaceutical database, Piccirillo and colleagues report that patients with acute uncomplicated sinusitis treated with an older, less expensive (first-line) antibiotic did not have significantly different treatment success rates compared with patients treated with a second-line antibiotic. The cost of care was significantly higher for patients treated with a second-line antibiotic.