在大型学术电脑中风网络中使用经过验证的中风模拟尺度对中风模拟的预测很差
Nikita Chhabra1, Stephen W English2, Richard J Butterfield3
1Department of Neurology, Mayo Clinic College of Medicine and Science, Phoenix, AZ, USA.
Journal of telemedicine and telecare
|August 19, 2024
概括
这项研究评估了四个尺度,用于识别电脑中风评估中的中风模仿. 没有一个尺度 (Khan分数,TeleStroke模拟分数,FABS,sFABS) 足够准确,足以保证临床使用.
科学领域:
- 神经学 神经学
- 远程医疗远程医疗
- 医学诊断 医学诊断 医学诊断
背景情况:
- 电脑中风服务对于远程急性中风评估至关重要.
- 脑卒中模仿者占远程脑卒中病例的30%以上,需要准确的识别.
- 现有的尺度旨在区分中风模仿与真正的缺血性中风.
研究的目的:
- 为了对外验证四个冲击模拟尺度:Khan分数 (KS),TeleStroke模拟分数 (TS),简化FABS (sFABS) 和FABS.
- 在一个大型的学术电脑冲击网络中评估这些秤的诊断性能.
主要方法:
- 在2019-2020年间通过电脑中风评估的1043名患者的回顾性研究.
- 查看图表,以提取适用于尺度应用的数据,并确认最终诊断 (缺血性中风与模仿).
- 计算了性能指标,包括曲线下面积 (AUC),灵敏度,特异性,PPV,NPV和精度.
主要成果:
- 电脑冲击模拟得分 (TS) 显示了最高的AUC (68.3%),灵敏度 (99.2%) 和NPV (77.3%).
- 汗分数 (KS) 获得了最高的准确性 (67.5%).
- 在FABS中,具有最高的特异性 (55.1%) 和PPV (72.5%).
结论:
- 没有一个单一的尺度有效地识别了中风模拟器,以获得自信的临床应用.
- 显著的临床判断对于评估电脑中风评估期间中风模仿的可能性至关重要.
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