Tomography Scan for the Detection of Elevated Intracranial Pressures in Patients with Acute Neurological Emergencies."We appreciate and thank the authors for their interest in our study and their detailed analysis.As the authors noted, the specificity (56.2%) of ultrasound (USG) guided optic nerve sheath diameter (ONSD) is low, but the sensitivity is 73.9%.For a test to be utilized as a screening tool, it must have high sensitivity; conversely, a test utilized as a diagnostic tool should have high specificity.In emergency clinical conditions, screening tools play a vital role to find the true positives rather than ruling out true negatives to intervene. 1 In these types of screening tools, high sensitivity with low specificity is acceptable.Since USGguided ONSD in our study has better sensitivity than specificity, we are convinced that it can be used as a screening tool to diagnose raised intracranial pressure (ICP) in an emergency situation.Hence, we did not include this low specificity as a limitation in our study.We agree with the authors that a subgroup analysis of our study population would have provided a clear picture regarding the utility of USG-guided ONSD, but unfortunately, we did not do a subgroup analysis for our study population.We are very much thankful for the authors for studying our research work with great interest.
Parameswaran et al. (Wed,) studied this question.