Canadian TIA risk score was not compared to clinician gestalt.

Would like to see this risk stratification applied to systems with different healthcare systems

Validation study done by the same group, in the same Canadian health system.

Used a composite outcome of a procedure (carotid revascularization) which is a subjective decision and subsequent stroke which is an objective diagnosis as the primary outcome.

Overall rate of outcome was low which would overestimate the performance of a clinical decision instrument since it was such a low-risk group.

20% of eligible patients were not enrolled (unclear why this occurred).

Canadian TIA score is a more complicated score to calculate compared to ABCD2.

Largest enough sample size to look at precision of subsequent stroke alone without considering carotid revascularization.

Near complete follow up with only 34 (0.4%) of patients missed by 7d.

Neither the ABCD2 nor the ABCD2i score was able to classify any patients as being low risk for the primary outcome (5%) based on previous surveys of ED physicians and neurologists.

Stratified Risk of Stroke, Carotid Endarterectomy/Carotid Artery Stenting or Both Within 7d (Primary Outcome):.

Interval likelihood ratios provide a better analysis than sensitivity and specificity because they assign a specific value to each level of abnormality which can be used to calculate posttest probability of disease for a given level of a test.When results of continuous data are expressed as binary outcomes using a single cutoff, distortion of data can occur because markedly abnormal values are lumped together with results that are only mildly abnormal.This is simply making diagnostic decisions based on a test result represented on a continuous scale.Authors use something called interval likelihood ratios (I had to look this term up):.Number of patients that fell into each risk group:.Only 5.8% of patients admitted to the hospital from the ED at the time of index visit.9 patients had both within 7d leaving 182 with outcomes.

83 (1.1%) had carotid endarterectomy/carotid artery stenting within 7d.108 (1.4%) had a subsequent stroke within 7d.7607 consecutively enrolled adult patients (80.6% of all potentially eligible patients).Treated with tPA or embolectomy for acute stroke.Presentation >7d after onset of neurological symptoms.Background: Patients who present with a transient ischemic attack (TIA) are at higher risk of subsequent stroke, especially in the short term (24hrs

Abcd 2 tia