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dc.contributor.authorKinsella, Justin A
dc.contributor.authorTobin, W Oliver
dc.contributor.authorCogan, Nicola
dc.contributor.authorMcCabe, Dominick J H
dc.date.accessioned2012-02-01T10:48:49Z
dc.date.available2012-02-01T10:48:49Z
dc.date.issued2012-02-01T10:48:49Z
dc.identifier.citationJ Neurol. 2011 Jun;258(6):1001-7. Epub 2010 Dec 25.en_GB
dc.identifier.issn1432-1459 (Electronic)en_GB
dc.identifier.issn0340-5354 (Linking)en_GB
dc.identifier.pmid21188409en_GB
dc.identifier.doi10.1007/s00415-010-5870-3en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207874
dc.description.abstractThe 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.
dc.language.isoengen_GB
dc.subject.meshAge Factorsen_GB
dc.subject.meshAgeden_GB
dc.subject.meshBlood Pressure/physiologyen_GB
dc.subject.mesh*Consensusen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIschemic Attack, Transient/*diagnosis/physiopathologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshNeurology/*methods/standardsen_GB
dc.subject.mesh*Observer Variationen_GB
dc.subject.meshPhysicians/psychologyen_GB
dc.subject.mesh*Severity of Illness Indexen_GB
dc.subject.meshSpecialization/*standardsen_GB
dc.titleInterobserver agreement in ABCD scoring between non-stroke specialists and vascular neurologists following suspected TIA is only fair.en_GB
dc.contributor.departmentDepartment of Neurology, The Adelaide and Meath Hospital, Dublin incorporating, National Children's Hospital, Trinity College Dublin, Tallaght, Dublin, 24,, Ireland.en_GB
dc.identifier.journalJournal of neurologyen_GB
dc.description.provinceLeinster
html.description.abstractThe 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.


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