These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Emergency physician's diagnosis of stroke subtype. An accuracy study.
    Author: Gomes Mda M, Costa MF, André C, Gomes R, Novis SA.
    Journal: Arq Neuropsiquiatr; 1998 Sep; 56(3B):523-7. PubMed ID: 9850744.
    Abstract:
    OBJECTIVE: To evaluate the accuracy of clinical unstructured and structured diagnosis of acute stroke subtypes--cerebral haemorrhage (CH), cerebral infarction (CI), subarachnoid haemorrhage (SAH). METHODS: Sixty consecutive patients with acute stroke admitted to the Emergency Ward of a Brazilian University Hospital were examined by emergency physicians and computerised tomography (CT). We also compared it (physician's unstructured diagnosis) to two published clinical scoring systems (structured diagnosis--Guy's Hospital and Siriraj Hospital) applied to three other populations--regarding the operational characteristics of the tests. RESULTS: In our personal data, among 9 variables that could discriminate CH and CI, three have statistically significant difference (p < 0.05): headache (p = 0.0002) and vomiting (p = 0.02) occurred more frequently in CH patients, but previous stroke in those with CI (p = 0.04). Unstructured diagnosis proved valid for SAH, with a +LHR = 39.7; and to a smaller degree for CI (-LHR = 0.1). However, it exhibited low sensitivity for the diagnosis of CH. Structured tests (Guy's Hospital and Siriraj Hospital) also failed to confidently diagnose stroke subtypes, especially CH. CONCLUSIONS: Both clinical diagnosis (made by emergency physicians) and the available diagnostic tests fail to confidently discriminate CH and CI.
    [Abstract] [Full Text] [Related] [New Search]