scholarly journals Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke

2021 ◽  
Author(s):  
Jacqueline K. Benfield ◽  
Gwenllian Wilkinson ◽  
Lisa F. Everton ◽  
Philip M. Bath ◽  
Timothy J. England
Keyword(s):  
Diagnostic Accuracy ◽  
Acute Stroke ◽  
Assessment Tool ◽  
Nurse Assessment ◽  
Trained Nurse

scholarly journals Diagnostic value of transcranial ultrasonography for selecting subjects with large vessel occlusion: a systematic review

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Daria Antipova ◽  
Leila Eadie ◽  
Ashish Stephen Macaden ◽  
Philip Wilson
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Acute Stroke ◽  
Clinical Assessment ◽  
Assessment Tools ◽  
Large Vessel ◽  
Cochrane Library ◽  
Direct Transfer ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion

Abstract Introduction A number of pre-hospital clinical assessment tools have been developed to triage subjects with acute stroke due to large vessel occlusion (LVO) to a specialised endovascular centre, but their false negative rates remain high leading to inappropriate and costly emergency transfers. Transcranial ultrasonography may represent a valuable pre-hospital tool for selecting patients with LVO who could benefit from rapid transfer to a dedicated centre. Methods Diagnostic accuracy of transcranial ultrasonography in acute stroke was subjected to systematic review. Medline, Embase, PubMed, Scopus, and The Cochrane Library were searched. Published articles reporting diagnostic accuracy of transcranial ultrasonography in comparison to a reference imaging method were selected. Studies reporting estimates of diagnostic accuracy were included in the meta-analysis. Results Twenty-seven published articles were selected for the systematic review. Transcranial Doppler findings, such as absent or diminished blood flow signal in a major cerebral artery and asymmetry index ≥ 21% were shown to be suggestive of LVO. It demonstrated sensitivity ranging from 68 to 100% and specificity of 78–99% for detecting acute steno-occlusive lesions. Area under the receiver operating characteristics curve was 0.91. Transcranial ultrasonography can also detect haemorrhagic foci, however, its application is largely restricted by lesion location. Conclusions Transcranial ultrasonography might potentially be used for the selection of subjects with acute LVO, to help streamline patient care and allow direct transfer to specialised endovascular centres. It can also assist in detecting haemorrhagic lesions in some cases, however, its applicability here is largely restricted. Additional research should optimize the scanning technique. Further work is required to demonstrate whether this diagnostic approach, possibly combined with clinical assessment, could be used at the pre-hospital stage to justify direct transfer to a regional thrombectomy centre in suitable cases.

A qualitative study using the Theoretical Domains Framework to investigate why patients were or were not assessed for rehabilitation after stroke

2016 ◽  
Vol 31 (7) ◽  
pp. 966-977 ◽  
Author(s):  
Elizabeth A Lynch ◽  
Julie A Luker ◽  
Dominique A Cadilhac ◽  
Caroline E Fryer ◽  
Susan L Hillier
Keyword(s):  
Qualitative Study ◽  
Acute Stroke ◽  
Health Professionals ◽  
Assessment Tool ◽  
Theoretical Domains Framework ◽  
Assessment Practices ◽  
Stroke Units ◽  
Changing Practice ◽  
Referral Practices ◽  
Rehabilitation Assessment

Objective: To explore the factors perceived to affect rehabilitation assessment and referral practices for patients with stroke. Design: Qualitative study using data from focus groups analysed thematically and then mapped to the Theoretical Domains Framework. Setting: Eight acute stroke units in two states of Australia. Subjects: Health professionals working in acute stroke units. Interventions: Health professionals at all sites had participated in interventions to improve rehabilitation assessment and referral practices, which included provision of copies of an evidence-based decision-making rehabilitation Assessment Tool and pathway. Results: Eight focus groups were conducted (32 total participants). Reported rehabilitation assessment and referral practices varied markedly between units. Continence and mood were not routinely assessed (4 units), and people with stroke symptoms were not consistently referred to rehabilitation (4 units). Key factors influencing practice were identified and included whether health professionals perceived that use of the Assessment Tool would improve rehabilitation assessment practices (theoretical domain ‘social and professional role’); beliefs about outcomes from changing practice such as increased equity for patients or conversely that changing rehabilitation referral patterns would not affect access to rehabilitation (‘belief about consequences’); the influence of the unit’s relationships with other groups including rehabilitation teams (‘social influences’ domain) and understanding within the acute stroke unit team of the purpose of changing assessment practices (‘knowledge’ domain). Conclusion: This study has identified that health professionals’ perceived roles, beliefs about consequences from changing practice and relationships with rehabilitation service providers were perceived to influence rehabilitation assessment and referral practices on Australian acute stroke units.

Temporal Validation of an Assessment Tool that Predicts a Possibility of Home Discharge for Patients with Acute Stroke

2022 ◽  
Vol 31 (1) ◽  
pp. 106188
Author(s):  
Takahiro Itaya ◽  
Yusuke Murakami ◽  
Akiko Ota ◽  
Ryo Shimomura ◽  
Tomoko Fukushima ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Assessment Tool ◽  
Home Discharge ◽  
Temporal Validation

Symptoms are the Most Effective Child SCAT5 Component for Recognizing Concussion on the Day of Injury

2021 ◽  
Author(s):  
Nicholas Kevin Erdman ◽  
Patricia M. Kelshaw ◽  
Samantha L. Hacherl ◽  
Shane V. Caswell
Keyword(s):  
Middle School ◽  
Diagnostic Accuracy ◽  
School Children ◽  
Assessment Tool ◽  
Diagnostic Odds Ratio ◽  
Likelihood Ratios ◽  
Middle School Children ◽  
Predictive Values ◽  
Symptom Evaluation ◽  
Diagnostic Properties

Abstract Background: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5) was developed to evaluate children between 5-12 years of age for a suspected concussion. However, limited empirical evidence exists demonstrating the value of the Child SCAT5 for acute concussion assessment. Therefore, the purpose of our study was to examine differences and assess the diagnostic properties of Child SCAT5 scores among concussed and non-concussed middle school children on the same day as a suspected concussion.Methods: Our participants included 34 concussed (21 boys, 13 girls; age=12.8±0.86 years) and 44 non-concussed (31 boys, 13 girls; age=12.4±0.76 years) middle school children who were administered the Child SCAT5 upon suspicion of a concussion. Child SCAT5 scores were calculated from the symptom evaluation (total symptoms, total severity), child version of the Standardized Assessment of Concussion (SAC-C), and modified Balance Error Scoring System (mBESS). The Child SCAT5 scores were compared between the concussed and non-concussed groups. Non-parametric effect sizes (r=z/√n) were calculated to assess the magnitude of difference for each comparison. The diagnostic properties (sensitivity, specificity, diagnostic accuracy, predictive values, likelihood ratios, and diagnostic odds ratio) of each Child SCAT5 score were also calculated.Results: Concussed children endorsed more symptoms (p<0.001, r=0.45), higher symptom severity (p<0.001, r=0.44), and had higher double leg (p=0.046, r=0.23), single leg (p=0.035, r=0.24), and total scores (p=0.022, r=0.26) for the mBESS than non-concussed children. No significant differences were observed for the SAC-C scores (p’s≥0.542). The quantity and severity of endorsed symptoms had the best diagnostic accuracy (AUC=0.76–0.77), negative predictive values (NPV=0.84–0.88), and negative likelihood ratios (-LR=0.22–0.31) of the Child SCAT5 scores.Conclusions: The symptom evaluation was the most effective component of the Child SCAT5 for differentiating between concussed and non-concussed middle school children on the same day as a suspected concussion.

scholarly journals Delirium Assessment in Acute Stroke: A Systematic Review and Meta-Analysis of Incidence, Assessment Tools, and Assessment Frequencies

2019 ◽  
Vol 11 ◽  
pp. 117957351989708
Author(s):  
Jannik Stokholm ◽  
Janni Vagner Steenholt ◽  
Claudio Csilag ◽  
Troels Wesenberg Kjær ◽  
Thomas Christensen
Keyword(s):  
Health Professional ◽  
Acute Stroke ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Assessment Tools ◽  
Significant Heterogeneity ◽  
Chi Square ◽  
Delirium Assessment ◽  
Retrospective Cohort Studies ◽  
Assessment Frequency

Purpose: The purpose of this systematic literature review was to examine whether different assessment methods contribute to the variance in delirium incidence detected in populations of patients with acute stroke. Specifically, the aim was to address the influence of (1) choice of assessment tool, (2) frequency of assessment, and (3) type of health professional doing the assessment. Methods: We searched MEDLINE, EMBASE, and PsycINFO and included pro- and retrospective cohort studies assessing delirium during hospitalization of adult acute stroke patients. Results: In 30 articles, 24 unique populations were identified and included in the review. Delirium incidence ranged from 1.4% to 75.6% in total and a chi-square test showed a significant heterogeneity across studies (χ2 = 536.5, df = 23, P < .0001). No studies had an assessment for delirium before a patient entered the study. No specific patterns regarding the influence of tool, assessment frequency or health professional were discernible. Discussion: Subgroups analyses were not conducted due to the heterogeneity across studies. Studies comparing delirium assessment tools directly with each other are needed. Conclusions: Delirium is a common complication in acute stroke. No firm conclusions about a possible correlation of choice of tool, assessment frequency, and delirium incidence could be made due to the great heterogeneity of the study populations. Only 1 study compared 2 tools directly with each other. Further studies comparing delirium assessment tools directly with each other are needed.

scholarly journals The diagnostic accuracy of the Kimberley Indigenous Cognitive Assessment (KICA) tool: a systematic review

2017 ◽  
Vol 25 (3) ◽  
pp. 282-287 ◽  
Author(s):  
Suzanne M Dyer ◽  
Kate Laver ◽  
Margeret Friel ◽  
Craig Whitehead ◽  
Maria Crotty
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Cognitive Assessment ◽  
Assessment Tool ◽  
Indigenous Australians ◽  
Indigenous Australian ◽  
Cross Sectional ◽  
Diagnosis Of Dementia ◽  
In Series ◽  
Similar Accuracy

Objectives: The objective of this study was to conduct a systematic review of evidence for the accuracy of the Kimberley Indigenous Cognitive Assessment (KICA) tool in supporting the diagnosis of dementia in Indigenous Australian populations. Methods: Cross-sectional diagnostic accuracy studies of the KICA with an appropriate reference standard published to November 2015 were included. Comparison to an alternative cognitive assessment tool was required in non-remote populations. Case control analyses were excluded. Results: Four studies were included: one of the KICA-Cog and KICA-Carer, one of the KICA Screen, and two of the modified-KICA. All tools developed for remote populations had a sensitivity of ≥76% and a specificity of ≥71% for the diagnosis of dementia. The KICA-Cog and KICA-Carer conducted in series had the highest sensitivity and specificity (91% and 94% respectively). In an urban and regional population, the mKICA had similar accuracy to the Mini-Mental State Examination (MMSE) (AUC 0.93, 95% CI 0.88–0.99 vs 0.94, 95% CI 0.89–0.99). Key risk of bias limitations related to lack of pre-determined cut-points and population selection methods. Conclusion: The use of the KICA in remote Indigenous Australians may assist in timely diagnosis of dementia in this population. Using the KICA-Cog and KICA-Carer in series may maximise specificity, decreasing false positive results without compromising sensitivity.

scholarly journals Toolkit of methodological resources to conduct systematic reviews

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 82
Author(s):  
Marta Roqué ◽  
Laura Martínez-García ◽  
Ivan Solà ◽  
Pablo Alonso-Coello ◽  
Xavier Bonfill ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Systematic Reviews ◽  
Assessment Tool ◽  
Research Question ◽  
Risk Of Bias ◽  
Bias Assessment ◽  
Assessment Development ◽  
Stage Of Development ◽  
Model Study ◽  
Question Development

Background: Systematic reviews (SR) can be classified by type depending on the research question they are based on. This work identifies and describes the most relevant methodological resources to conduct high-quality reviews that answer clinical questions regarding prevalence, prognosis, diagnostic accuracy and efficacy of interventions. Methods: Methodological resources have been identified from literature searches and consulting guidelines from institutions that develop SRs. The selected resources are organized by type of SR, and stage of development of the review (formulation of the research question, development of the protocol, literature search, risk of bias assessment, synthesis of findings, assessment of the quality of evidence, and report of SR results and conclusions). Results: Although the different types of SRs are developed following the same steps, each SR type requires specific methods, differing in characteristics and complexity. The extent of methodological development varies by type of SR, with more solid guidelines available for diagnostic accuracy and efficacy of interventions SRs. This methodological toolkit describes the most up-to-date risk of bias instruments: Quality in Prognostic Studies (QUIPS) tool and Prediction model study Risk Of Bias Assessment Tool (PROBAST) for prognostic SRs, Quality assessment of diagnostic accuracy studies tool (QUADAS-2) for diagnostic accuracy SRs, Cochrane risk of bias tool (ROB-2) and Risk of bias in non-randomised studies of interventions studies tool (ROBINS-I) for efficacy of interventions SRs, as well as the latest developments on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Conclusions: This structured compilation of the best methodological resources for each type of SR may prove to be a very useful tool for those researchers that wish to develop SRs or conduct methodological research works on SRs.

scholarly journals Validation of a palliative care outcome measurement tool supplemented by neurological symptoms (HOPE+): Identification of palliative concerns of neurological patients

2019 ◽  
Vol 33 (9) ◽  
pp. 1221-1231
Author(s):  
Kim Dillen ◽  
Markus Ebke ◽  
Andreas Koch ◽  
Ingrid Becker ◽  
Christoph Ostgathe ◽  
...  
Keyword(s):  
Palliative Care ◽  
Diagnostic Accuracy ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Outcome Measurement ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Measurement Tool ◽  
Operating Characteristics ◽  
Neurological Patients

Background: There is growing interest to integrate palliative care and its structures into the care of neurological patients. However, in Germany there is no comprehensive assessment tool capturing the symptoms of patients with advanced neurological diseases. Aim: To validate a newly developed palliative care measurement tool based on an extension of the validated core documentation system Hospice and Palliative Care Evaluation considering additional neurological issues (HOPE+). Design: Prospective, observational study using HOPE+ and as external criteria, the Eastern Cooperative Oncology Group (ECOG) performance status and the 12 months “surprise” question (12-SQ) in a neurological population, and assessment for its construct validity and diagnostic accuracy. Setting/participants: All newly admitted patients to the Department of Neurorehabilitation, Dr. Becker Rhein-Sieg-Clinic aged 18–100 years (#DRKS00010947). Results: Data from 263 patients (63 ± 14 years of age) were analyzed. HOPE+ revealed a moderately correlated six-factor structure ( r = –0.543–0.525). Correlation analysis to evaluate discriminant validity using ECOG as external criterion was high ( rs(261) = 0.724, p < 0.001) and confirmed for severely affected patients by adding the 12-SQ (“No”-group: 48.00 ± 14.92 vs “Yes”-group: 18.67 ± 7.57, p < 0.009). Operating characteristics show satisfactory diagnostic accuracy (area under the curve: 0.746 ± 0.049, 95% confidence interval = 0.650–0.842). Conclusion: HOPE+ demonstrates promising psychometric properties. It helps to assess palliative care issues of patients in neurological settings and, in combination with the 12-SQ, conceivably conditions when to initiate the palliative care approach in a population underrepresented in palliative care structures so far.

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