What is the clinical evidence from this study?

Study design: Cohort. Population: Transient ischemic attack and minor ischemic stroke (n=594). Intervention: ABCD2 score vs. Noncerebrovascular events. Primary outcome: Discrimination of any vascular event (TIA and minor ischemic stroke) from noncerebrovascular events (c-statistic 0.7, 95% CI 0.66-0.74).

What question did this study set out to answer?

Determine whether the ABCD2 clinical prediction tool can reliably distinguish transient ischemic attack and minor ischemic stroke from noncerebrovascular conditions.

September 11, 2009StrokeOpen Access

Diagnostic Usefulness of the ABCD 2 Score to Distinguish Transient Ischemic Attack and Minor Ischemic Stroke From Noncerebrovascular Events

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Key result

The ABCD2 score effectively discriminated any cerebrovascular event (TIA and minor ischemic stroke) from noncerebrovascular events (c-statistic 0.7; 95% CI 0.66-0.74).

Why the study?

Does the ABCD2 score improve discrimination of true TIA and minor ischemic stroke from noncerebrovascular events in patients referred to a TIA clinic?

Population

594 consecutive patients referred to a daily TIA clinic, including 292 with TIA, 45 with minor ischemic…

Design

Cohort, Diagnosis was assigned by a trained stroke physician independent of…

Authors

OSOrla C. SheehanUniversity College Dublin ÁMÁine MerwickUniversity College Cork LKLisa A. KellyUniversity of Southern Queensland

Discussion

Member takes

Implication

Supports ABCD2 discrimination of events in TIA referrals; leaves open prospective validation before routine adoption.

Key Points

Determine whether the ABCD2 clinical prediction tool can reliably distinguish transient ischemic attack and minor ischemic stroke from noncerebrovascular conditions.
Prospective population-based cohort study evaluating 594 consecutive patients referred to a daily clinic for suspected transient ischemic attack (TIA).
Diagnoses of TIA (n=292), minor ischemic stroke (MIS, n=45), or noncerebrovascular events (n=257) were confirmed by a stroke physician independently of ABCD2 scoring.
Mean ABCD2 scores demonstrated a significant graded increase from noncerebrovascular events (2.9, SD 1.5) to TIA (3.9, SD 1.5) and MIS (4.8, SD 1.4; P < 0.00001).
The score showed diagnostic discrimination between noncerebrovascular events and TIA (c-statistic 0.68; 95% CI, 0.64 to 0.72), combined vascular events (c-statistic 0.70; 95% CI, 0.66 to 0.74), and MIS (c-statistic 0.81; 95% CI, 0.75 to 0.87).
Unilateral weakness (OR 4.5; 95% CI, 3.1 to 6.6) and speech disturbance (OR 2.5; 95% CI, 1.6 to 4.1) were the strongest individual score components separating TIA from noncerebrovascular mimics.

Study Design

Type

Cohort (n=594)

Structured PICO

Does the ABCD2 score improve discrimination of true TIA and minor ischemic stroke from noncerebrovascular events in patients referred to a TIA clinic?

Population

594 consecutive patients referred to a daily TIA clinic, comprising 292 with TIA, 45 with minor ischemic stroke, and 257 with noncerebrovascular events.

Exposure

ABCD2 score assessment

Outcome

Discrimination of true TIA and minor ischemic stroke from noncerebrovascular events

Main Result

Effect estimate: c-statistic 0.7 (95% CI 0.66-0.74)

The ABCD2 score has significant diagnostic utility in distinguishing true TIA and minor ischemic stroke from noncerebrovascular events, which may aid in clinical risk stratification.

Cite This Study

Sheehan et al. (2009) conducted a cohort in Transient ischemic attack and minor ischemic stroke (n=594). ABCD2 score vs. Noncerebrovascular events was evaluated on Discrimination of any vascular event (TIA and minor ischemic stroke) from noncerebrovascular events (c-statistic 0.7, 95% CI 0.66-0.74). The ABCD2 score effectively discriminated any cerebrovascular event (TIA and minor ischemic stroke) from noncerebrovascular events (c-statistic 0.7; 95% CI 0.66-0.74).

synapsesocial.com/papers/6a6f5243a7fbea1e4407b7db https://doi.org/10.1161/strokeaha.109.557074

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Diagnostic Usefulness of the ABCD 2 Score to Distinguish Transient Ischemic Attack and Minor Ischemic Stroke From Noncerebrovascular Events

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Diagnostic Usefulness of the ABCD 2 Score to Distinguish Transient Ischemic Attack and Minor Ischemic Stroke From Noncerebrovascular Events

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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