The Edinburgh Trauma Triage Clinic (TTC) streamlines outpatient
care through consultant-led ‘virtual’ triage of referrals and the
direct discharge of minor fractures from the Emergency Department.
We compared the patient outcomes for simple fractures of the radial
head, little finger metacarpal, and fifth metatarsal before and
after the implementation of the TTC. A total of 628 patients who had sustained these injuries over
a one-year period were identified. There were 337 patients in the
pre-TTC group and 289 in the post-TTC group. The Disabilities of
the Arm, Shoulder and Hand Score (QuickDASH) or Foot and Ankle Disability
Index (FADI), EuroQol-5D (EQ-5D), visual analogue scale (VAS) pain
score, satisfaction rates, and return to work/sport were assessed
six months post-injury. The development of late complications was
excluded by an electronic record evaluation at three years post-injury.
A cost analysis was performed.Aims
Patients and Methods
Outcome measures quantifying aspects of health in a precise,
efficient, and user-friendly manner are in demand. Computer adaptive
tests (CATs) may overcome the limitations of established fixed scales
and be more adept at measuring outcomes in trauma. The primary objective
of this review was to gain a comprehensive understanding of the
psychometric properties of CATs compared with fixed-length scales
in the assessment of outcome in patients who have suffered trauma
of the upper limb. Study designs, outcome measures and methodological
quality are defined, along with trends in investigation. A search of multiple electronic databases was undertaken on 1
January 2017 with terms related to “CATs”, “orthopaedics”, “trauma”,
and “anatomical regions”. Studies involving adults suffering trauma
to the upper limb, and undergoing any intervention, were eligible.
Those involving the measurement of outcome with any CATs were included.
Identification, screening, and eligibility were undertaken, followed
by the extraction of data and quality assessment using the Consensus-Based
Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.
The review is reported according to the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses (PRISMA) criteria and reg istered (PROSPERO: CRD42016053886).Aims
Materials and Methods
