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dc.contributor.authorSnaith, Beverly
dc.contributor.authorWalker, A.
dc.contributor.authorRobertshaw, S.
dc.contributor.authorSpencer, N.J.B.
dc.contributor.authorSmith, A.
dc.contributor.authorHarris, M.A.
dc.date.accessioned2020-11-17T16:02:43Z
dc.date.accessioned2020-12-01T14:52:50Z
dc.date.available2020-11-17T16:02:43Z
dc.date.available2020-12-01T14:52:50Z
dc.date.issued2020
dc.identifier.citationSnaith B, Walker A, Robertshaw S et al (2020) Has NICE guidance changed the management of the suspected scaphoid fracture: A survey of UK practice. Radiography. Accepted for Publication.en_US
dc.identifier.urihttp://hdl.handle.net/10454/18184
dc.descriptionYesen_US
dc.description.abstractIntroduction: Despite scaphoid fractures being relatively uncommon pro-active treatment of suspected fractures has been seen as a risk management strategy. The poor positive predictive value of X-rays has led to published guidelines advocating MRI as a first-line or early imaging tool. It is unclear whether UK hospitals have been able to introduce early scanning and this national survey sought to establish the current management strategies for patients with a suspected scaphoid fracture. Method: An electronic survey of UK emergency departments (ED) was conducted to establish the initial and follow up strategies for patients with negative imaging. Comparison of first and second-line imaging modalities was undertaken together with review of the clinical speciality responsible for ongoing management. Results: 166 UK NHS Trusts were identified with emergency department facilities of which 66 (39.8%) responded. All sites perform an X-ray as the initial examination. For those with a negative examination ED follow up was the most common approach (54.6%), although many sites refer patients to other specialities including orthopaedics (39.4%) for follow up. The data demonstrated inconsistencies in the number of follow-up episodes and the different imaging investigations utilised. Frustration with the challenges presented by this patient cohort was evident. Conclusion: The suspected scaphoid fracture represents an ongoing challenge to the NHS with many resource intensive pathways reliant on access to complex imaging investigations. Implications for practice: Our study identified that UK Emergency Departments have limited early access to complex imaging for scanning of the scaphoid. A range of strategies are used for follow up of suspected scaphoid fractures and these are resource intensive. Overtreatment of patients with suspected scaphoid fracture is used as a risk management approach.en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1016/j.radi.2020.09.014en_US
dc.rights© 2020 The College of Radiographers. Published by Elsevier Ltd. All rights reserved. Reproduced in accordance with the publisher's self-archiving policy. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.en_US
dc.subjectScaphoiden_US
dc.subjectFractureen_US
dc.subjectOcculten_US
dc.subjectImagingen_US
dc.subjectRisken_US
dc.titleHas NICE guidance changed the management of the suspected scaphoid fracture: A survey of UK practiceen_US
dc.status.refereedYesen_US
dc.date.Accepted2020-09-16
dc.date.application2020-09-30
dc.typeArticleen_US
dc.date.EndofEmbargo2021-10-01
dc.type.versionAccepted manuscripten_US
dc.description.publicnotesThe full-text of this article will be released for public view at the end of the publisher embargo on 01 Oct 2021.en_US
dc.date.updated2020-11-17T16:02:44Z
refterms.dateFOA2020-12-01T14:54:30Z


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