Evidence map›Paper›PMID 39680237›Full record

ArticleJournal of neurology2024

Field-testing the explicit diagnostic criteria for transient ischemic attack: a diagnostic accuracy study.

Adrian Scutelnic, Seraina Michèle Auf der Maur, Mattia Branca, Morin Beyeler, Thomas Horvath, Philip Bücke, Thomas Meinel, Elena R Lebedeva, Jes Olesen, Franz Riederer and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

17 authors.

Adrian ScutelnicDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Seraina Michèle Auf der MaurDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Mattia BrancaCTU Bern, University of Bern, Bern, Switzerland.
Morin BeyelerDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Thomas HorvathDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Philip BückeDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Thomas MeinelDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Elena R LebedevaDepartment of Neurology, The Ural State Medical University, Yekaterinburg, Russia.
Jes OlesenDanish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
Franz RiedererDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Tomas DobrockyInstitute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Bern, Switzerland.
Jan GrallaInstitute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Urs FischerDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Heinrich P MattleDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Simon JungDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Christoph J SchankinDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland. christoph.schankin@insel.ch.ORCID http://orcid.org/0000-0003-4668-6098

Funding

Schweizerische Herzstiftung FF21070
6 · The paper itself

Abstract

BACKGROUND AND

aimExplicit diagnostic criteria for transient ischemic attack (TIA) (EDCT) have been recently proposed based on the assumption, that a migraine aura-like symptom is not typical for a TIA. However, migraine-like symptoms have been unexpectedly frequent in patients with confirmed ischemic stroke. This cross-sectional study aimed to field-test the EDCT to distinguish transient neurological symptoms caused by cerebral infarction from those caused by migraine aura.

methodsThe sensitivity, specificity, positive and negative predictive values of the EDCT score were calculated in samples of patients with (i) transient symptoms caused by cerebral infarction confirmed by imaging and (ii) patients with migraine with aura diagnosed according to the International Classification of Headache Disorders 3rd edition. Sensitivity, specificity, positive and negative predictive values of the original and modified EDCT were calculated, as well as area under the curve adjusted for age and sex using the logistic regression method.

resultsThe study population included 59 patients with cerebral infarction and 324 patients with migraine with aura. The median age of the stroke group was 72 (IQR 61-81) and of the migraine group 39 (IQR 29-53). There were 36 (61%) men in the stroke group and 221 (68%) women in the migraine group. For the detection of TIA with imaging-proven cerebral infarction, the original EDCT had a sensitivity of 90% (95%CI 79-96), a specificity 77% (95%CI 72-82), a positive predictive value of 42% (95%CI 33-51), and the negative predictive value 98% (95% CI 95-99). For the modified EDCT, the sensitivity was 81% (95%CI 69-90), the specificity 97% (95%CI 94-98), the positive predictive value 81% (95%CI 69-90), and the negative predictive value 97% (95%CI 94-98).

conclusionsThe original and modified EDCT criteria miss up to 1 of 10 and 1 of 5 patients, respectively, with transient symptoms due to cerebral infarction. However, the modified EDCT criteria are more specific but less sensitive in detection of ischemic events. The optimal combination of clinical markers to reliably distinguish TIA from migraine aura remains to be found.

Indexed as

Ischemic Attack, TransientSensitivity and SpecificityAdultAgedAged, 80 and overCerebral InfarctionCross-Sectional StudiesDiagnosis, DifferentialFemaleHumansMaleMiddle AgedMigraine with AuraPredictive Value of Testsaccuracyischemic strokeMigraine aurascoretransient ischemic attack

Identifiers

PMID39680237
PMCPMC11649740

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.