PERSPECTIVE
The CHALICE rule
The CHALICE rule: ready for prime time?
Correspondence to:
Correspondence to:
R Forsyth
Department of Child Health, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK; r.j.forsyth@newcastle.ac.uk
Perspective on the paper by Dunning et al (see page 885)
| The first 150 words of the full text of this article appear below. |
The paper by Dunning et al1 in this issue discusses a classic medical screening problem. Particularly during the long, light summer evenings, every accident and emergency department in the country sees large numbers of children who have sustained traumatic head injuries, most of which seem trivial; but among such children, there are a small number who are at avoidable risk of severe disability or death. How can they be identified most effectively? In the reported series of around 20 000 children, 95% had not even a brief loss of consciousness and 97% had a Glasgow Coma Scale of 15, but at the tip of the severity pyramid were 281 (1.2%) children with abnormal computed tomograms, 137 (0.6%) of whom required a neurosurgical procedure, and 15 deaths (although the paper does comment on how many of these deaths were deemed potentially preventable).
The authors point out the weakness
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