Systematic Review and Pooled Analysis of Published and Unpublished Validations of the ABCD and ABCD2 Transient Ischemic Attack Risk Scores
Key result
The ABCD and ABCD2 scores demonstrated good predictive value for stroke at 7 days post-TIA, with a pooled AUC of 0.72 (95% CI 0.63-0.80; P<0.001) for the ABCD2 score across all relevant cohorts.
Why the study?
Do the ABCD and ABCD2 scores accurately predict early risk of stroke at 7 days in patients with transient ischemic attack?
Population
9,808 subjects with transient ischemic attack from 20 cohorts
Design
Meta-analysis
Follow-up
7 days
Authors
Discussion
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Member takes
Implication
Supports ABCD2 for post-TIA risk stratification; confirms predictive validity across cohorts.
Study Design
Type
Systematic Review (n=9,808)
Multicenter
Yes
Structured PICO
Do the ABCD and ABCD2 scores accurately predict early risk of stroke at 7 days in patients with transient ischemic attack?
P
Population
9,808 subjects with transient ischemic attack from 20 cohorts
I
Intervention
ABCD and ABCD2 risk scores
O
Outcome
Prediction of stroke at 7 days (measured by pooled area under the receiver operator characteristic curve [AUC])hard clinical
Main Result
Effect estimate: Pooled AUC 0.72 (95% CI 0.63 to 0.80)
p-value: p=<0.001
The ABCD and ABCD2 scores demonstrate good predictive value for 7-day stroke risk after TIA, particularly when based on face-to-face clinical evaluation rather than retrospective chart review.
Limitations
- Lower predictive value in studies based on retrospective extraction of nonsystematically collected data from emergency department records
Cite This Study
Giles et al. (2010) conducted a systematic review in Transient Ischemic Attack (n=9,808). ABCD and ABCD2 scores was evaluated on Prediction of stroke at 7 days (Pooled AUC 0.72, 95% CI 0.63 to 0.80, p=<0.001). The ABCD and ABCD2 scores demonstrated good predictive value for stroke at 7 days post-TIA, with a pooled AUC of 0.72 (95% CI 0.63-0.80; P<0.001) for the ABCD2 score across all relevant cohorts.