Evidence map›Paper›PMID 34017173›Full record

ReviewNeuropsychiatric disease and treatment2021

Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes.

Emma J C Wallace, Ava L Liberman

Open access · goldAbstract readReview
In one paragraph

Review in Neuropsychiatric disease and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.4field-weighted citation impact, top 19% 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

10 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
  2. Prehospital stroke care in low- and middle-income countries: A World Stroke Organization (WSO) scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025
    Review
  3. Article
  4. Review
  5. Stroke chameleons: Diagnostic challenges.European journal of radiology open · 2023
    Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments.Journal of the American Medical Informatics Association : JAMIA · 2021
    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

2 authors at 1 institution in 1 country.

Emma J C WallaceMontefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USA.ORCID 0000-0003-3275-0538
Ava L LibermanMontefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USA.ORCID 0000-0003-0184-6035
Albert Einstein College of Medicine · US

Funding

The Misdiagnosis of Cerebrovascular Disease in Emergent Headache EvaluationsK23NS107643 · NINDS · WEILL MEDICAL COLL OF CORNELL UNIV · PI LIBERMAN, AVA L · 2018 to 2022
$997k
NINDS NIH HHS K23 NS107643
6 · The paper itself

Abstract

Failure to diagnose transient ischemic attack (TIA) or stroke in a timely fashion is associated with significant patient morbidity and mortality. In the outpatient or clinic setting, we suspect that patients with minor, transient, and atypical manifestations of cerebrovascular disease are most prone to missed or delayed diagnosis. We therefore detail common stroke chameleon symptoms as well as atypical stroke presentations, broadly review new developments in the study of diagnostic error in the outpatient setting, suggest practical clinical strategies for diagnostic error reduction, and emphasize the need for rapid consultation of stroke specialists when appropriate. We also address the role of psychiatric disease and vascular risk factors in the diagnostic evaluation and treatment of suspected stroke/TIA patients. We advocate incorporating diagnostic time-outs into clinical practice to assure that the diagnosis of TIA or stroke is considered in all relevant patient encounters after a detailed history and examination are conducted in the outpatient setting.

Indexed as

cerebrovascular diseasediagnostic errorstrokestroke chameleons

Identifiers

PMID34017173
PMCPMC8129915
OpenAlexW3160715117

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.