The principles underpinning the KHR may potentially be applicable to other imaging protocols in resource-limited healthcare environments (Fig.
We report on the first year of utilisation of the KHR.
To determine the sensitivity and specificity of the KHR in identifying patients with clinically significant intracranial pathology requiring acute change in management.
Based on the clinical evaluation, the KHR determined the need for and priority of, CTB.
The primary outcome was analysed by determining the sensitivity and specificity of the KHR as an indication of the accuracy of the clinical guideline in practice, which could then be compared with the existing international guidelines.
The 18 clinically significant intracranial lesions requiring acute change in management that were missed by the KHR were as follows: hypertensive intraparenchymal haemorrhages (n=5), ruptured cerebral artery aneurysms with associated subarachnoid haemorrhages (n=4), arteriovenous malformation with an associated subarachnoid haemorrhage (n=1), and ischaemic infarcts (all presenting after 6 hours) (n=8).
It is noteworthy that the lower sensitivity of the KHR applies only to the immediate CTB group.
On subgroup data analysis, the KHR achieved 100% sensitivity and 33.
A limitation is our relatively small study sample in this review of the first year of clinical utilisation of the KHR.
However, based on used minus available vegetation (Table 3), we compiled a qualitative assessment of possible preference and possible avoidance for the 50% KHR (Fig.
The use of a 50% KHR to represent a core-area for migratory landbirds is widely supported in the literature (e.
Table 1--Maximum daily and seasonal movements and estimates of home range (MCP = 100%-minimum-convex-polygon; KHR = fixed-kemel-home-range) of radio-marked yellow-billed cuckoos (Coccyzus american us occidentalis) along three reaches (N = Narrows, D = Delta, M = Mainstem) of the Middle Rio Grande, New Mexico, in 2007 and 2008.