Mild paediatric head injury: The diagnostic value of physical examinations compared with computed tomographic scans

Farizal Fadzil, Mohd Safari Mohd Haspani

Research output: Contribution to journalArticle

Abstract

The study objective was to determine the diagnostic value of physical examinations for positive computer tomography (CT) scans in children with mild head injuries. Retrospective data of patients evaluated for mild head injuries with loss of consciousness (LOC) or amnesia were reviewed. Estimations of prevalence, sensitivity, specificity, and predictive values were calculated. Agreement between the physical examinations and CT brain scans was calculated using the Kappa test. 225 patients were included in the study. Of this group, 19.56% of patients had positive CT scans, and 7.56% had normal physical examinations. 15 underwent neurosurgical intervention. For positive CT scans, sensitivity and specificity were 61.36% and 60.22%, respectively. Agreement between physical examinations and CT scans was Kappa = 0.147 (P < 0.05), 95% CI (0.035, 0.259). The present study demonstrated that physical examinations were significantly associated with positive CT scans (P = 0.01). However, the calculated Kappa value showed only slight agreement between these 2 variables, and the low sensitivity and specificity of the physical examinations suggest that intracranial pathology in children with mild head injuries and LOC or amnesia cannot be excluded based on physical examinations alone.

Original languageEnglish
Pages (from-to)64-68
Number of pages5
JournalMalaysian Journal of Medical Sciences
Volume19
Issue number3
Publication statusPublished - Jul 2012

Fingerprint

Craniocerebral Trauma
Physical Examination
Pediatrics
Tomography
Amnesia
Unconsciousness
Sensitivity and Specificity
Pathology
Brain

Keywords

  • CT scan
  • Diagnostic value
  • Mild head injury
  • Physical examination
  • Sensitivity
  • Specificity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mild paediatric head injury : The diagnostic value of physical examinations compared with computed tomographic scans. / Fadzil, Farizal; Haspani, Mohd Safari Mohd.

In: Malaysian Journal of Medical Sciences, Vol. 19, No. 3, 07.2012, p. 64-68.

Research output: Contribution to journalArticle

@article{3a63c49d698d418c8da6f2323f085d94,
title = "Mild paediatric head injury: The diagnostic value of physical examinations compared with computed tomographic scans",
abstract = "The study objective was to determine the diagnostic value of physical examinations for positive computer tomography (CT) scans in children with mild head injuries. Retrospective data of patients evaluated for mild head injuries with loss of consciousness (LOC) or amnesia were reviewed. Estimations of prevalence, sensitivity, specificity, and predictive values were calculated. Agreement between the physical examinations and CT brain scans was calculated using the Kappa test. 225 patients were included in the study. Of this group, 19.56{\%} of patients had positive CT scans, and 7.56{\%} had normal physical examinations. 15 underwent neurosurgical intervention. For positive CT scans, sensitivity and specificity were 61.36{\%} and 60.22{\%}, respectively. Agreement between physical examinations and CT scans was Kappa = 0.147 (P < 0.05), 95{\%} CI (0.035, 0.259). The present study demonstrated that physical examinations were significantly associated with positive CT scans (P = 0.01). However, the calculated Kappa value showed only slight agreement between these 2 variables, and the low sensitivity and specificity of the physical examinations suggest that intracranial pathology in children with mild head injuries and LOC or amnesia cannot be excluded based on physical examinations alone.",
keywords = "CT scan, Diagnostic value, Mild head injury, Physical examination, Sensitivity, Specificity",
author = "Farizal Fadzil and Haspani, {Mohd Safari Mohd}",
year = "2012",
month = "7",
language = "English",
volume = "19",
pages = "64--68",
journal = "Malaysian Journal of Medical Sciences",
issn = "1394-195X",
publisher = "Universiti Sains Malaysia",
number = "3",

}

TY - JOUR

T1 - Mild paediatric head injury

T2 - The diagnostic value of physical examinations compared with computed tomographic scans

AU - Fadzil, Farizal

AU - Haspani, Mohd Safari Mohd

PY - 2012/7

Y1 - 2012/7

N2 - The study objective was to determine the diagnostic value of physical examinations for positive computer tomography (CT) scans in children with mild head injuries. Retrospective data of patients evaluated for mild head injuries with loss of consciousness (LOC) or amnesia were reviewed. Estimations of prevalence, sensitivity, specificity, and predictive values were calculated. Agreement between the physical examinations and CT brain scans was calculated using the Kappa test. 225 patients were included in the study. Of this group, 19.56% of patients had positive CT scans, and 7.56% had normal physical examinations. 15 underwent neurosurgical intervention. For positive CT scans, sensitivity and specificity were 61.36% and 60.22%, respectively. Agreement between physical examinations and CT scans was Kappa = 0.147 (P < 0.05), 95% CI (0.035, 0.259). The present study demonstrated that physical examinations were significantly associated with positive CT scans (P = 0.01). However, the calculated Kappa value showed only slight agreement between these 2 variables, and the low sensitivity and specificity of the physical examinations suggest that intracranial pathology in children with mild head injuries and LOC or amnesia cannot be excluded based on physical examinations alone.

AB - The study objective was to determine the diagnostic value of physical examinations for positive computer tomography (CT) scans in children with mild head injuries. Retrospective data of patients evaluated for mild head injuries with loss of consciousness (LOC) or amnesia were reviewed. Estimations of prevalence, sensitivity, specificity, and predictive values were calculated. Agreement between the physical examinations and CT brain scans was calculated using the Kappa test. 225 patients were included in the study. Of this group, 19.56% of patients had positive CT scans, and 7.56% had normal physical examinations. 15 underwent neurosurgical intervention. For positive CT scans, sensitivity and specificity were 61.36% and 60.22%, respectively. Agreement between physical examinations and CT scans was Kappa = 0.147 (P < 0.05), 95% CI (0.035, 0.259). The present study demonstrated that physical examinations were significantly associated with positive CT scans (P = 0.01). However, the calculated Kappa value showed only slight agreement between these 2 variables, and the low sensitivity and specificity of the physical examinations suggest that intracranial pathology in children with mild head injuries and LOC or amnesia cannot be excluded based on physical examinations alone.

KW - CT scan

KW - Diagnostic value

KW - Mild head injury

KW - Physical examination

KW - Sensitivity

KW - Specificity

UR - http://www.scopus.com/inward/record.url?scp=84863822493&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863822493&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:84863822493

VL - 19

SP - 64

EP - 68

JO - Malaysian Journal of Medical Sciences

JF - Malaysian Journal of Medical Sciences

SN - 1394-195X

IS - 3

ER -