Open AccessExplicit Diagnostic Criteria for Transient Ischemic Attacks Used in the Emergency Department Are Highly Sensitive and Specific
Author(s) -
Carl Göbel,
Sarah Karstedt,
Thomas F. Münte,
Hartmut Göbel,
Sebastian Wolfrum,
Elena R. Lebedeva,
Jes Olesen,
Georg Royl
Publication year - 2020
Publication title -
cerebrovascular diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 104
eISSN - 1421-9786
pISSN - 1015-9770
DOI - 10.1159/000512182
Subject(s) - medicine , emergency department , gold standard (test) , economic shortage , emergency medicine , diagnostic accuracy , medical diagnosis , medical emergency , radiology , psychiatry , linguistics , philosophy , government (linguistics)
Background: Making a correct diagnosis of a transient ischemic attack (TIA) is prone to errors because numerous TIA mimics exist and there is a shortage of evidence-based diagnostic criteria for TIAs. In this study, we applied for the first time the recently proposed explicit diagnostic criteria for transient ischemic attacks (EDCT) to a group of patients presenting to the emergency department of a large German tertiary care hospital with a suspected TIA. The aim was to determine the sensitivity and specificity of the EDCT in its clinical application. Methods: A total of 128 patients consecutively presenting to the emergency department of the University Hospital of Lübeck, Germany, under the suspicion of a TIA were prospectively interviewed about their clinical symptoms at the time of presentation. The diagnosis resulting from applying the EDCT was compared to the diagnosis made independently by the senior physicians performing the usual diagnostic work-up (“gold standard”), allowing calculation of sensitivity and specificity of the EDCT. Results: EDCT achieved a sensitivity of 96% and a specificity of 88%. When adding the additional criterion F (“the symptoms may not be better explained by another medical or mental disorder”), specificity significantly increased to 98%. Conclusions: The data show that the EDCT in its modified version as proposed by us are a highly useful tool for clinicians. They display a high sensitivity and specificity to accurately diagnose TIAs in patients referred to the emergency department with a suspected TIA.