Evidence map›Paper›PMID 29374105›Full record

ArticleStroke2018

Validating the TeleStroke Mimic Score: A Prediction Rule for Identifying Stroke Mimics Evaluated Over Telestroke Networks.

Syed F Ali, Gordian J Hubert, Jeffrey A Switzer, Jennifer J Majersik, Roland Backhaus, L Wylie Shepard, Kishore Vedala, Lee H Schwamm

Open access · bronzeAbstract readEvaluation StudyMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
3.7field-weighted citation impact, top 6% 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

21 citing papers in PubMed, 36 citations in OpenAlex.

  1. Trial
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  8. Article
  9. Thrombolysis of stroke mimics via telestroke.Stroke and vascular neurology · 2022
    Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Thrombolytic Refusal Over Telestroke.Neurology. Clinical practice · 2021
    Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. The Accuracy of Large Vessel Occlusion Recognition Scales in Telestroke Setting.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2019
    Article
  20. 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

8 authors at 2 institutions in 1 country.

Syed F AliFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.).
Gordian J HubertFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.).
Jeffrey A SwitzerFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.).
Jennifer J MajersikFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.).
Roland BackhausFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.).
L Wylie ShepardFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.).
Kishore VedalaFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.).
Lee H SchwammFrom the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (S.F.A., L.H.S.); Department of Neurology and Neurological Intensive Care, Staedtisches Klinikum München, TeleMedical Project for integrative Stroke Care, Munich, Germany (G.J.H.); Department of Neurology, Augusta University, GA (J.S., K.V.); Division of Vascular Neurology, University of Utah, Salt Lake City (J.J.M., L.W.S.); and Department of Neurology, University Regensburg, Germany (R.B.). lschwamm@partners.org.
Augusta University · USUniversity of Utah · US

Funding

UT StrokeNetU10NS086606 · NINDS · UNIVERSITY OF UTAH · PI MAJERSIK, JENNIFER JUHL · 2013 to 2017
$1.8M
NINDS NIH HHS U10 NS086606
6 · The paper itself

Abstract

background and purposeUp to 30% of acute stroke evaluations are deemed stroke mimics, and these are common in telestroke as well. We recently published a risk prediction score for use during telestroke encounters to differentiate stroke mimics from ischemic cerebrovascular disease derived and validated in the Partners TeleStroke Network. Using data from 3 distinct US and European telestroke networks, we sought to externally validate the TeleStroke Mimic (TM) score in a broader population.

methodsWe evaluated the TM score in 1930 telestroke consults from the University of Utah, Georgia Regents University, and the German TeleMedical Project for Integrative Stroke Care Network. We report the area under the curve in receiver-operating characteristic curve analysis with 95% confidence interval for our previously derived TM score in which lower TM scores correspond with a higher likelihood of being a stroke mimic.

resultsBased on final diagnosis at the end of the telestroke consultation, there were 630 of 1930 (32.6%) stroke mimics in the external validation cohort. All 6 variables included in the score were significantly different between patients with ischemic cerebrovascular disease versus stroke mimics. The TM score performed well (area under curve, 0.72; 95% confidence interval, 0.70-0.73;

conclusionsThe TM score's ability to predict the presence of a stroke mimic during telestroke consultation in these diverse cohorts was similar to its performance in our original cohort. Predictive decision-support tools like the TM score may help highlight key clinical differences between mimics and patients with stroke during complex, time-critical telestroke evaluations.

Indexed as

Decision MakingBrain IschemiaFemaleHumansMaleStrokeTelemedicinearea under curvecerebrovascular disorderscohort studieshumansrisk

Identifiers

PMID29374105
PMCPMC5829006
OpenAlexW2790556889

What OpenQuestion holds

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Registered trials

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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.