All you need to read in the other general journalsBMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d1457 (Published 09 March 2011) Cite this as: BMJ 2011;342:d1457
New rule helps predict who will walk again after a spinal injury
Researchers have developed and validated a tool to help predict who will eventually walk unaided after a traumatic spinal cord injury. The tool requires a simple neurological examination within 15 days of injury to score light touch sensation and power in both L3 and S1. After factoring in age, patients are given a score between −10 and 40 that doctors can translate into a probability of independent walking, using a graph⇓.
Researchers derived their prediction rule using prospective data from 492 patients injured between 2001 and 2008, and validated it in a smaller dataset from 99 patients injured in 2008 and 2009. All were admitted to one of 19 collaborating centres in Europe. In the validation study, the rule accurately discriminated between patients who did and did not walk unaided after one year (area under receiver operating characteristics curve 0.967, 95% CI 0.939 to 0.995; P<0.0001).
Will I ever walk again? Is one of the first things patients ask, says a linked comment (doi:10.1016/S0140-6736(11)60248-1). Neurologists and others have been looking for accurate prognostic indicators for half a century. This new rule adds to an emerging consensus that giving patients what they want is at least possible. Further work is planned to find out how they might benefit. The researchers hope their rule will improve patients’ psychological wellbeing and help set realistic rehabilitation goals.
Prednisolone tablets improve symptoms of nasal polyposis
The latest trial of oral corticosteroids for nasal polyposis tested a commonly used strategy that starts with a short course of oral prednisolone, followed by much longer treatment with nasal steroid drops or spray. Controls took a placebo in place of prednisolone for the first two weeks. Patients given the active treatment did better at first. Their polyps shrank significantly more than controls and their sense of smell improved more than controls. By the …
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