Dr. Ian Stiell – Making the Rules

Dr. Ian StiellIn 1991, the emergency room staff saw numerous ankle sprains every day, but didn’t pay much attention to them, assuming every one needed an X-ray. Because 90 percent of people who twist their ankle don’t have a break but a sprain that normally heals in a couple of days, emergency physician and senior scientist Dr. Ian Stiell devised guidelines, or decision rules, to help physicians decide if the patient needs an X-ray.

The Ottawa RULES app

 “While the Ottawa Ankle Rules are well known around the world, they are actually the seedlings that started the whole program of decision rules we are now studying,” said Dr. Stiell. 

The Ottawa Knee Rule, Canadian CT Head Rule for concussions, the Canadian C-Spine Rule for spinal injuries, the Canadian Heart Failure Risk Scale and the Ottawa COPD Scale for patients with chronic obstructive pulmonary disease are other decision rules that Dr. Stiell has developed to provide objective guidance for emergency room doctors to determine the necessity of imaging and other tests that can be costly, expose the patient to unnecessary radiation, and mean more time spent waiting in the hospital.

Read more about three decision rules that changed practice worldwide

Read more about Research to Improve Patient Care at The Ottawa Hospital

Watch Dr. Stiell’s video about emergency medicine research:

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