Validity of the ABCD2 prediction rule for strokes

January 01, 0001

Validity of the ABCD2 prediction rule for strokes

The ABCD2 clinical prediction rule was designed to predict the near term risk of stroke following a TIA. These Irish researchers performed a systematic literature search for validation studies of ABCD2. They compared observed and predictive strokes in three risk groups: low (0-3 points), moderate (4-5 points) and high (6-7 points). They calculated risk ratios (RRs) for each group in terms of over-prediction (RR > 1) or under-prediction (RR < 1) of stroke at 7 and 90 days.

The researchers report: "We include 16 validation studies. Fourteen studies report 7-day stroke risk (n = 6282, 388 strokes). The ABCD2 rule correctly predicts occurrence of stroke at 7 days across all three risk strata: low (RR 0.86), moderate (RR 0.99)and high (RR 0.84). Eleven studies report 90-day stroke risk (n = 6304). There is a non-significant trend towards over-prediction of stroke in all risk categories at 90 days. There are 426 strokes observed in contrast to a predicted 626 strokes. As the trichotomized ABCD2 score increases, the risk of stroke increases. There is no evidence of publication bias in these studies."

The researchers concluded: "The ABCD2 is a useful CPR, particularly in relation to 7-day risk of stroke."

The ABCD2 is an accurate predictor of stroke risk across risk strata in the near term.


For the full abstract, click here.

Family Practice 28(4):366-376, April 2011 © 2011 Oxford University Press
Prognostic value of the ABCD2 clinical prediction rule: a systematic review and meta-analysis. Rose Galvin, Colm Geraghty, Nicola Motterlini, Borislav D Dimitrov and Tom Fahey. Correspondence to Rose Galvin: [email protected]

Category: N. Neurological. Keywords: ABCD2, clinical prediction rule, transient ischemic attack, TIA, stroke, systematic review and meta-analylsis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 19 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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