Journal Club Summary
Methodology Score: 4/5
Usefulness Score: 4/5
Perry JJ, Sharma M, Sivilotti ML, Sutherland J, Symington C, Worster A, Émond M, Stotts G, Jin AY, Oczkowski WJ, Sahlas DJ, Murray HE, MacKey A, Verreault S, Wells GA, Stiell IG.
This prospective validation of the ABCD2 clinical decision enrolled 2,056 patients with TIA and found that the sensitivities and specificities for prediction of stroke or TIA at 7 and 90 days were too low to match what surveyed EM and Neurologists stated as clinically significant [primary outcome stroke at 7 days: sensitivity 31.6% (CI 19.1-47.5), specificity 79.7% (CI 77.9-81.4)]. The group felt that the rule was not a useful tool for prediction of subsequent events, and that more research was necessary to create a clinical decision rule which would determine the urgency of follow up for patients with TIA.
By: Dr. Chris Fabian