Derivation and Internal Validation of a Prediction Model for Hand Fracture Referral Among Pediatric Patients

Simple item page
dc.contributor.advisorRonksley, Paul Everett
dc.contributor.authorHartley, Rebecca Lauren
dc.contributor.committeememberFaris, Peter D.
dc.contributor.committeememberFraulin, Frankie O. G.
dc.contributor.committeememberHarrop, Alan Robertson
dc.date2019-11
dc.date.accessioned2019-06-19T16:32:02Z
dc.date.available2019-06-19T16:32:02Z
dc.date.issued2019-06-18
dc.description.abstractPediatric hand fractures are common however, which fractures should be referred for specialist care remains unclear. This thesis aimed to develop a prediction model to identify which acute pediatric hand fractures required referral to a hand surgeon. Data was collected on consecutively referred pediatric hand fractures to a plastic surgery clinic over two years. The primary outcome was necessary referral, defined as fractures that required surgery, closed reduction or more than four appointments. Multivariable logistic regression with bootstrapping was used to derive and internally validate a model, which was then translated into a risk index. Of 1,173 fractures, 417 (35.6%) met criteria for a necessary referral. The multivariable model identified six significant predictors: angulation, condylar involvement, dislocation or subluxation, displacement, open fractures, and rotation and had strong performance (C-statistic 0.88). The risk index, with a threshold 1 point, had a sensitivity of 96.4% and specificity of 45.5%. A simple prediction model was developed to identify which acute pediatric hand fractures required referral to a hand surgeon. While these results require external validation prior to clinical use, this tool may help identify high risk patients and allow for targeted referral.en_US
dc.identifier.citationHartley, R. L. (2019). Derivation and Internal Validation of a Prediction Model for Hand Fracture Referral Among Pediatric Patients (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/36644
dc.identifier.urihttp://hdl.handle.net/1880/110508
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectpediatricen_US
dc.subjecthand fractureen_US
dc.subjectprediction modelen_US
dc.subject.classificationEpidemiologyen_US
dc.subject.classificationMedicine and Surgeryen_US
dc.titleDerivation and Internal Validation of a Prediction Model for Hand Fracture Referral Among Pediatric Patientsen_US
dc.typemaster thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrue
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
ucalgary_2019_hartley_rebecca.pdf
Size:
2.3 MB
Format:
Adobe Portable Document Format
Description:
Main thesis
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.74 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Open Theses and Dissertations