Evidence map›Paper›PMID 29158247›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2017

Predictive values of referrals for transient ischaemic attack from first-contact health care: a systematic review.

Rebecca Kandiyali, Daniel S Lasserson, Penny Whiting, Alison Richards, Jonathan Mant

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Rebecca KandiyaliBristol Medical School, University of Bristol, Bristol.
Daniel S LassersonInstitute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham.
Penny WhitingBristol Medical School, University of Bristol, Bristol, and NIHR CLAHRC West, Bristol.
Alison RichardsNIHR CLAHRC West, Bristol.
Jonathan MantPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge.
University of Birmingham · GBUniversity of Bristol · GBUniversity of Cambridge · GB

Funding

Department of Health PB-PG-1207-15216
6 · The paper itself

Abstract

backgroundOver 150 000 cases of suspected transient ischaemic attack (TIA) are referred to outpatient clinics in England each year. The majority of referrals are made by GPs.

aimThis study aimed to identify how many patients referred to a TIA clinic actually have TIA (that is, calculate the positive predictive value [PPV] of first-contact healthcare referral) and to record the alternative diagnoses in patients without TIA, in order to determine the optimal service model for patients with suspected TIA. DESIGN AND

settingA systematic review of TIA clinic referrals from first-contact health professionals (GPs and emergency department [ED] doctors) was undertaken.

methodFour databases were searched using terms for TIA and diagnostic accuracy. Data on the number of patients referred to a TIA clinic who actually had a TIA (PPVs) were extracted. Frequencies of differential diagnoses were recorded, where reported. Study quality was assessed using the QUADAS-2 tool.

resultsNineteen studies were included and reported sufficient information on referrals from GPs and ED doctors to derive PPVs (

conclusionThis study highlights the variation in prevalence of true vascular events in patients referred to TIA clinics. For patients without a cerebrovascular diagnosis, the high prevalence of conditions that also require specialist investigations and management are an additional burden on a care pathway that is primarily designed to prevent recurrent stroke. Service commissioners need to assess whether the existing outpatient provision is optimal for people with pathologies other than cerebrovascular disease.

Indexed as

General PracticeClinical ProtocolsEnglandHumansIschemic Attack, TransientPractice Patterns, Physicians'Referral and ConsultationStrokediagnosisgeneral practitionersischaemic attack, transientpredictive value of testsprimary health carestroke

Identifiers

PMID29158247
PMCPMC5697557
OpenAlexW2769539133

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.