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Ann Emerg Med. 1999 Apr;33(4):437-47.

Methodologic standards for the development of clinical decision rules in emergency medicine.

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  • 1Division of Emergency Medicine, Departments of Medicine, Epidemiology and Community Medicine, Ottawa Hospital Loeb Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada.


The purpose of this review is to present a guide to help readers critically appraise the methodologic quality of an article or articles describing a clinical decision rule. This guide will also be useful to clinical researchers who wish to answer 1 or more questions detailed in this article. We consider the 6 major stages in the development and testing of a new clinical decision rule and discuss a number of standards within each stage. We use examples from emergency medicine and, in particular, examples from our own research on clinical decisions rules for radiography in trauma.

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