![]() The prevalence of fracture in these patients ranged from 10% to 80% using a reference standard such as magnetic resonance imaging, radiography, or bone scan. The patients ranged in age from 7 to 84 years. The 6 studies assessed the accuracy of 2 tuning-fork test methods (pain induction and reduction of sound transmission). Six primary studies (329 patients) were included in the review. Data for the primary outcome measure (accuracy of the test) were presented in a 2 × 2 contingency table to show sensitivity and specificity (using the Wilson score method) and positive and negative likelihood ratios with 95% confidence intervals.Ī total of 62 citations were initially identified. A third researcher was consulted if the 2 initial reviewers did not reach consensus. The QUADAS-2 is an updated version of the original QUADAS and focuses on both the risk of bias and applicability of a study through a series of questions. All relevant articles were included and assessed for inclusion criteria and value using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, and relevant data were extracted. Potentially eligible studies were independently assessed by 2 researchers. Studies were not eligible if they were case series, case-control studies, or narrative review papers. Studies included patients of all ages in all clinical settings with no exclusion for language of publication. Studies were eligible based on the following criteria: (1) primary studies that assessed the diagnostic accuracy of tuning forks (2) measured against a recognized reference standard such as magnetic resonance imaging, radiography, or bone scan and (3) the outcome was reported using pain or reduction of sound. The following key words were used independently or in combination: auscultation, barford test, exp fractures, fracture, tf test, tuning fork. In addition, they manually searched reference lists from the initial search result to identify relevant studies. ![]() The authors performed a comprehensive literature search of AMED, CAB Abstracts, CINAHL, EMBASE, MEDLINE, SPORTDiscus, and Web of Science from each database's start to November 2012. 2014 4(8):e005238.ĭoes evidence support the use of tuning-fork tests in the diagnosis of fractures in clinical practice? Is there sufficient evidence for tuning fork tests in diagnosing fractures? A systematic review. Boatman, et al.Mugunthan K, Doust J, Kurz B, Glasziou P. How accurate are bedside hearing tests? Neurology 2007 68: 1311-1314 American Hearing Research Foundation.2002 when there is suspicion of hearing loss, audiometry should be performed even if bedside tests are normal.(2).Rinne and Weber tests do not reliably predict the presence and type of hearing loss (2).bedside tests are unreliable screening tools for detection of hearing loss (2,3).commonly used bedside tuning folk tests are:.If the tuning fork is pressed firmly against the skull the note is transmitted directly to the cochlea by the process of bone conduction. the tuning fork is first held with its acoustic axis in line with the external auditory meatus - the sound being heard via the process of air conduction.the tuning fork should be struck against one's elbow or knee, and not against a bedside table or desk as this produces undesirable harmonics.one should use a 512Hz tuning fork with a flattened base.these allow one to distinguish between conductive and sensorineural deafness.
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