Studnek 2013.
| Study characteristics | |||
| Patient sampling | 7 hospitals under 2 healthcare systems, USA Sampling: retrospective analysis of patient records; people were included in this study if they received a prehospital MedPACS screen and were transported to 1 of the 7 local hospitals |
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| Patient characteristics and setting |
Inclusion and exclusion criteria: Inclusion: signs or symptoms of acute stroke or TIA Exclusion: no documented assessment, ages < 18 years, secondary transports Participant characteristics: mean age 66.8 (SD 16.7) years; 45.7% men |
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| Index tests |
Index test: CPSS, MedPACS Test administrator: paramedics Training: 2‐hour continuing education lecture regarding neurologic emergencies |
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| Target condition and reference standard(s) |
Target condition: stroke/TIA Reference standard: discharge diagnosis of stroke or TIA |
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| Flow and timing | 52 participants with no stroke screen performed or incomplete results | ||
| Comparative | |||
| Diagnostic test accuracy data |
Prevalence of stroke/TIA: 186/416 (44.7%) MedPACS: TP = 138; FP = 155; FN = 48; TN = 75 CPSS: TP = 147; FP = 175; FN = 39; TN = 55 |
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| Notes |
Categorization of alternate diagnosis for participants who did not have an ischemic stroke: not reported Funding: not reported |
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| Methodological quality | |||
| Item | Authors' judgement | Risk of bias | Applicability concerns |
| DOMAIN 1: Patient Selection | |||
| Was a consecutive or random sample of patients enrolled? | No | ||
| Was a case‐control design avoided? | Yes | ||
| Did the study avoid inappropriate exclusions? | Unclear | ||
| Prospective design | No | ||
| High | Low | ||
| DOMAIN 2: Index Test Index tests | |||
| Were the index test results interpreted without knowledge of the results of the reference standard? | Yes | ||
| If a threshold was used, was it pre‐specified? | Yes | ||
| Low | Low | ||
| DOMAIN 3: Reference Standard | |||
| Is the reference standards likely to correctly classify the target condition? | Unclear | ||
| Were the reference standard results interpreted without knowledge of the results of the index tests? | Unclear | ||
| Unclear | Low | ||
| DOMAIN 4: Flow and Timing | |||
| Was there an appropriate interval between index test and reference standard? | Unclear | ||
| Did all patients receive the same reference standard? | Unclear | ||
| Were all patients included in the analysis? | Yes | ||
| Did all patients receive a reference standard? | Unclear | ||
| Unclear | |||