PEDIATRICS Vol. 82 No. 2 August 1988, pp. 285-286
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Physical Examination for Brain Injury

FREDERICK P. RIVARA MD, MPH1, DARIK TANAGUCHI BS1, RUTH ANN PARISH MD1, GARY STIMAC MD, PHD1, and BETH MUELLER DRPH1

1 Department of Pediatrics, Harborview Medical Center, Seattle, WA 98104

In Reply.—

Drs Margolis and Nichols believe that our study does not provide adequate support for the suggestion that "clinical criteria are inadequate guides to the decision to use head CT." The main thrust of their argument is that

[See Figure in the Table]

the prevalence of disease seen at Harborview Medical Center is likely to be much greater than that seen in physicians' offices and community hospitals and that this prevalence affects the predictive value of clinical signs.