Birmingham Mandible and Midface Rules
Research type
Research Study
Full title
The Birmingham Mandible and Midface Fracture Clinical Predictor Rules
IRAS ID
265956
Contact name
Ross Elledge
Contact email
Sponsor organisation
UHBFT
Duration of Study in the UK
1 years, 0 months, 6 days
Research summary
This study would be a prospective data gathering exercise of all suspected mandibular and mid-face fractures attending an emergency department at a major trauma centre over a fixed period. Selected variables from clinical examination findings by frontline clinicians would be gathered prior to the point of requesting a radiograph to confirm/refute the presence of a facial fracture. The relationship between variables and the likelihood of detecting a fracture would be examined using a method of statistical analysis called recursive partitioning analysis to generate a clinical predictor rule for the likelihood of fractures. This would then be validated to determine the potential of the rule to minimise the number of unnecessary radiographs (and in turn patient radiation exposure and demand on resources) taken by frontline staff for suspected facial fractures.
Lay summary of study results: A total of 116 patients were included in the final data analysis. For the purposes of data stratification, 28 (24.1%) demonstrated any fracture with 9 (7.8%) of the total cohort having sustained a zygomatic fracture and 19 (16.4%) showing mandibular fractures.
Discriminant analysis was performed using cross validated Least Absolute Shrinkage and Selection Operator (LASSO) regression. Forward stepwise procedure was performed, maximising the Jaccard Index of a predictor against target outcome. Combining the results from the LASSO regression analysis and forward stepwise Jaccard procedure yields a predictor rule with three mandibular predictors and six zygomatic predictors with 96.4% sensitivity and 56.5% specificity.
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
19/NW/0587
Date of REC Opinion
13 Sep 2019
REC opinion
Favourable Opinion