Purpose: Identify patients with neck pain likely to improve with cervical traction and exercise.
Rule:
1. Patient reported peripheralization with lower cervical spine (C4-7) mobility testing
2. Positive shoulder abduction test
3. Age greater than 55
4. Positive upper limb tension test or brachial stretch test
5. Positive cervical distraction test
| Item | 3+ variable | 4+ variables |
| SN | 0.63 | 0.30 |
| SP | 0.87 | 1.00 |
| +LR | 4.81 | 23.1 |
| -LR | ||
| POS | 79% | 95% |
SN = sensitivity – ‘SnOut’ helps rule out a disease (higher number is better – >0.9 is excellent)
SP = Specificity – ‘SpIn’ helps rule in a disease (higher number is better – greater than 0.90 is excellent))
+LR = positive likelihood ratio – ratio of positive test results in a patients with the pathology (true positives) higher number is better (> 10 is excellent)
-LR = negative likelihood ratio – ratio of negative test results in a patients with the pathology (false negatives) lower number is better (< 0.1 is excellent)
POS = Probability of success – positive treatment outcome
References:
Raney NH, et al. Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise. Eur Spine J. 2009; 18(3): 382-91.
