Table 1

Impact Analysis Studies of Clinical Prediction Rules (16 Studies Covering 12 Rules)

Clinical DomainClinical Prediction RuleAuthor, YearClinical SettingStudy DesignStudy Outcome
D (Digestive)
 D14: Hematemesis/vomiting bloodBlatchford scoreStanley et al, 200919Emergency departmentBefore-afterPositive
 D88: AppendicitisAlvarado score (MANTRELS)Farahnak et al, 200720Emergency departmentRCT (pilot)Positive
K (Cardiovascular)
 K22: Risk factors for cardiovascular diseaseUKPDS risk engine (patients with diabetes) with Dutch guidelines risk tableKoelewijnvan Loon et al, 200921Primary careCluster RCTNegative
New Zealand risk guidelines for cardiovascular diseaseMontgomery et al, 200022Primary careCluster RCTNegative
 K74: Ischemic heart disease with anginaPozen 1984 for admission in acute ischemic heart diseasePozen et al, 198423Emergency departmentOn-offPositive
 K93: Pulmonary embolismCharlotte ruleKline et al, 200424Emergency departmentBefore-after (controlled)Positive
Wells rule for PEWells et al, 200325Emergency departmentCluster RCTPositive
L (Musculoskeletal)
 L73: Fracture tibia/fibulaOttawa ankle ruleBessen et al, 200926Emergency departmentBefore-afterPositive
Ottawa ankle ruleAuleley et al, 199727Emergency departmentRCTPositive
Ottawa ankle ruleStiell et al, 199528Emergency departmentBefore-after (controlled)Positive
Ottawa ankle ruleStiell et al, 199429Emergency departmentBefore-after (controlled)Positive
Ottawa knee ruleStiell et al, 199730Emergency departmentBefore-after (controlled)Positive
N (Neurologic)
 N81: Injury nervous system otherCanadian cervical-spine ruleStiell et al, 200931Emergency departmentCluster RCTPositive
R (Respiratory)
 R72: Streptococcal pharyngitisCentor scoreWorrall et al, 200732Primary careRCTNegative
McIsaac ruleMcIssac et al, 200233Primary careRCTNegative
McIsaac ruleMcIssac and Goel, 199834Primary careRCTPositive
  • MANTRELS = migration to the right iliac fossa, anorexia, nausea/vomiting, tenderness in the right iliac fossa, rebound pain, elevated temperature (fever), leukocytosis, and shift of leukocytes to the left; PE = pulmonary embolism; RCT = randomized controlled trial; UKPDS = UK Prospective Diabetes Study.