Clinical prediction rules

Abstract

A “clinical prediction rule” is a set of variables used to assist clinicians in their evaluation of a patient at risk for a particular disease or disorder. The goal of a prediction rule is to promote efficiency, and decrease the rate of errors of omission (those resulting from omitting a necessary action) and commission (errors resulting from inappropriate action). Prediction rules are created by identifying variables (from patient history, physical examination, and selected diagnostic testing) associated with (i.e., predictive of) a particular outcome, typically with the use of multivariable analysis. Prediction rules are developed from scientific study and not by expert consensus (i.e., practice guidelines). By applying the prediction rule to patients with a particular clinical presentation, a course of action is suggested or indicated. Evaluating and treating trauma patients is prone to inefficiencies and errors because of the clinical uncertainties of caring for acutely injured patients under time constraints. This chapter outlines the development and use of clinical prediction rules in the injured patient.