| The difficulties that practitioners face during the process of diagnosing carpal navicular fractures impede preventative measures against conditions such as avascular necrosis, non-unions and radiographic osteoarthritis. The purpose of this quantitative study was to test whether performances of the evaluators and the imagers are directly related to the likelihood (or DOR) of detection of bone fractures. Quantitative meta-analysis, with Bayesian theorem, was applied to assess the performances of the imaging predictors. QRS reached the gold standard level (AUC = 1.00, DOR = 9.20, summary statistic Q * = .98); for nMRI (AUC = .99, DOR = 6.60, summary statistic Q * = .97); and CT scanners (AUC = .99, DOR = 6.10, summary statistic Q * = .98). For the evaluators, the best performer was tenderness of anatomic snuffbox area (DOR = 6.69); navicular compression tenderness second (DOR = 6.06); and tenderness over navicular tubercle third (DOR = 3.85). Practitioners' results included: inconsistencies in the practice protocol; lack of a[n] universally acceptable gold standard; lack of consensus in support of having universal navicular protocol; and radiography, prob(SS + | NF + ) ≃60%, is still used most frequently during the initial phase of the diagnosis. Social change implications include assembling authorities with the objective of producing and making the best performing imagers like QRS, nMRI, and CT scanners affordable and available for the practitioners. These findings will aid positive social change by eliminating the current inconsistent choices of modalities in the practice thereby allowing for prompt and accurate diagnoses of navicular fractures to be established so that correct treatments can be initiated to help the sufferers of navicular fractures. |
