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    Interobserver agreement in ABCD scoring between non-stroke specialists and vascular neurologists following suspected TIA is only fair.

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    Authors
    Kinsella, Justin A
    Tobin, W Oliver
    Cogan, Nicola
    McCabe, Dominick J H
    Affiliation
    Department of Neurology, The Adelaide and Meath Hospital, Dublin incorporating, National Children's Hospital, Trinity College Dublin, Tallaght, Dublin, 24,, Ireland.
    Issue Date
    2012-02-01T10:48:49Z
    MeSH
    Age Factors
    Aged
    Blood Pressure/physiology
    *Consensus
    Female
    Humans
    Ischemic Attack, Transient/*diagnosis/physiopathology
    Male
    Middle Aged
    Neurology/*methods/standards
    *Observer Variation
    Physicians/psychology
    *Severity of Illness Index
    Specialization/*standards
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    Citation
    J Neurol. 2011 Jun;258(6):1001-7. Epub 2010 Dec 25.
    Journal
    Journal of neurology
    URI
    http://hdl.handle.net/10147/207874
    DOI
    10.1007/s00415-010-5870-3
    PubMed ID
    21188409
    Abstract
    The appropriateness of use and accuracy of age, blood pressure, clinical features and duration of symptoms (ABCD) scoring by non-stroke specialists while risk-stratifying patients with suspected transient ischaemic attack (TIA) are unknown. We reviewed all available ABCD data from referrals to a specialist neurovascular clinic. ABCD scoring was defined as 'appropriate' in this study if an experienced vascular neurologist subsequently confirmed a clinical diagnosis of possible, probable or definite TIA, and 'inappropriate' if the patient had an alternative diagnosis or stroke. Interobserver agreement between the referring physician and the neurologist was calculated. One hundred and four patients had completed ABCD referral proformas available for analysis. Forty-five (43%) were deemed appropriate, and 59 (57%) inappropriate. In the entire dataset, the neurologist agreed with the referring physician's total ABCD score in only 42% of cases [kappa = 0.28]. The two most unreliable components of the scoring system were clinical features [kappa = 0.51], and duration of symptoms [kappa = 0.48]. ABCD scoring by non-stroke specialists is frequently inappropriate and inaccurate in routine clinical practice, emphasising the importance of urgent specialist assessment of suspected TIA patients.
    Language
    eng
    ISSN
    1432-1459 (Electronic)
    0340-5354 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00415-010-5870-3
    Scopus Count
    Collections
    Tallaght University Hospital

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