Summaries of Independent Scientist (K) Awards

Blackmore, Christopher C.

Institution: University of Washington, Seattle, WA
Grant Title: Clinical Prediction Rule for Pelvic Fracture Hemorrhage
Grant Number:  K08 HS11291
Duration: 5 years (2000-2005)
Total Award: $625,100

Project Description: The purpose of this project was to develop and validate a simple instrument to determine which subjects with pelvic fracture have a high probability of major hemorrhage.  The project had four main goals:

1. Determine the relationship between measured pelvic hemorrhage volume and outcome, through computer tomography (CT) scan-based measurement of pelvic hemorrhage and retrospective chart review of outcome on a cohort of 400 patients with pelvic fracture.
2. Develop the prediction rule through the evaluation of medical records and pelvic radiographs on a cohort of 1000 pelvic fracture patients from 7 trauma centers.
3. Assess the reliability of the radiographic predictors by evaluating the agreement of 12 readers on a set of 25 pelvic radiographs.
4. Conduct a multi-center prospective validation of the prediction rule involving 750 subjects at three trauma centers.

Career Goals: Dr. Blackmore's overall career goal is to examine and improve the role of radiology in optimizing efficiency in patient care at the patient and system levels.  In particular, he will develop and apply clinical prediction rules and other decision-making tools to aid-cost effective use of emergency radiology services.  The K grant allowed him to gain practical experience through the development and validation of the pelvic hemorrhage prediction rule.  Dr. Blackmore will establish a network of regional trauma centers that will facilitate future investigations.

Progress to Date: Dr. Blackmore completed his K grant in 2005.  Phase I of this project involved validation of the use of pelvic hemorrhage volume measured from CT scan as a surrogate for actual patient outcomes of transfusion requirement, death, or demonstrated arterial extravasation. Phase II developed a clinical prediction rule from the radiographic and clinical information that was available at the time of initial presentation for trauma care.  The grantee also developed an internet-based system for simultaneous interpretation and reporting of study subject radiographs which enabled assessment of intra-observer agreement of the potential clinical prediction rule criteria.  The final phase of the research was to prospectively validate the clinical prediction rule.

Highlights and Specific Accomplishments:

• Promoted to Professor of Radiology, University of Washington School of Medicine, and Adjunct Professor of Health Services, University of Washington School of Public Health and Community Medicine.
• Promoted to Associate Director of Radiology for Evidence Based Practice, Harborview Medical Center, University of Washington.
• Named as Deputy Editor of Academic Radiology, Assistant Editor of the American journal of Roentgenology (AJR), and member of the Editorial Board of the Journal of the American College of Radiology (JACR).
• Invited to deliver the Opening Address to the Radiological Society of North America on "Clinical Prediction Rules in Trauma Imaging".
• Named as a Fellow of the American Society of Emergency Radiology
• Invited as visiting expert advisor to the Nordic Trauma Evidence Based Consensus Conference on Cervical Spine Imaging in Trauma.
• Elected President of the Radiology Alliance for Health Services Research 2005-2006.

K-Generated Publications:

Blackmore CC.  Critically assessing the radiology literature. Academic Radiology N2004. 11:134-40.

Blackmore CC, Jurkovich GJ, Linnau KF, et al. Assessment of volume hemorrhage and outcome from pelvic fracture. Archives of Surgery 2003. 138:504-09.

Blackmore CC, Richardson ML, Linnau KF, et al. Computers in radiology:  Web-based image review and data acquisition for multi-institution research. American Journal of Radiology 2003.180:1243-46.

Blackmore CC, Cummings P. Observational studies in radiology. American Journal of Radiology 2004.183:1203-08.

Blackmore CC. Introduction to clinical research for radiologists. American Journal of Radiology 2001. 176:327-32.

Beam CA, Blackmore CC, Karlik S, Reinhold C. Fundamentals of clinical research for radiologists: Editor's introduction to the series. American Journal of Radiology 2001. 176:323-27.

Sheridan MK, Blackmore CC, Linnau KF, et al. Can CT predict the source of arterial hemorrhage in patients with pelvic fracture. Emergency Radiology 2002. 9:188-94.

Blackmore CC. Evidence-based imaging evaluation of the cervical spine in trauma. Neuroimaging Clinical North American 2003. 13:283-92.

Stambuagh LE, Blackmore CC. Pelvic ring disruptions in emergency radiology. European Journal of Radiology 2003. 48:71-87.

Terasawa T. Blackmore CC, Bent S, Kohlwes RJ. Computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents: A systematic review and meta analysis. Annals of Internal Medicine 2005.141:537-46.

Bub L, Blackmore VV, Mann FA, Lomoschitz FM. Cervical spine fractures in patients 65 years old: A clinical prediction rule for blunt trauma. Radiology. 2005. 234:143-49.

Blackmore CC. Clinical prediction rules in trauma imaging: Who, how, and why? Radiology 2005. 235:371-74.

Blackmore CC, Cummings P, Jurkovich GJ, et al. Predicting major hemorrhage in patients with pelvic fracture. Journal of Trauma 2006. 61:346-52.

Basta, AM, Blackmore CC, Wessells H. Predicting urethral injury from pelvic fracture patterns in male patients with blunt trauma. Journal of Urology 2007. 177:571-75.

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