Prognostic value of the ABCD2 clinical prediction rule: a systematic review and meta-analysis
Open accessAbstract
OBJECTIVE: The purpose of this systematic review with meta-analysis is to determine the predictive value of the ABCD ²at 7 and 90 days across three strata of risk. Background. The risk of stroke after transient ischaemic attack (TIA) is significant. The ABCD ²clinical prediction rule is designed to predict early risk of stroke after TIA. A number of independent validation studies have been conducted since the rule was derived. METHODS: A systematic literature search was conducted to identify studies that validated the ABCD². The derived rule was used as a predictive model and applied to subsequent validation studies. Comparisons were made between observed and predicted number of strokes stratified by risk group: low (0-3 points), moderate (4-5 points) and high (6-7 points). Pooled results are presented as risk ratios (RRs) with 95% confidence intervals (CIs), in terms of over-prediction (RR > 1) or under-prediction (RR < 1) of stroke at 7 and 90 days. RESULTS: 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, 95% CI (0.47-1.58), I² = 16%], moderate [RR 0.99, 95% CI (0.67-1.47), I² = 68%] and high [RR 0.84, 95% CI (0.6-1.19), I² = 46%]. 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 (P < 0.01). There is no evidence of publication bias in these studies (P > 0.05). CONCLUSION: The ABCD² is a useful CPR, particularly in relation to 7-day risk of stroke.
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ABCD2 score predicts the risk of recurrent stroke soon after a transient ischemic attack (TIA).
“ABCD2 score | Predict the risk of recurrent stroke soon after a transient ischemic attack (TIA).”
From Blockchain and Artificial Intelligence Technology in E-Health (2021) · cites this paper as Galvin et al. 2011 & Uchiyama et al. 2019
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- Authors
- Galvin, R., Geraghty, C., Motterlini, N., Dimitrov, B. D., & Fahey, T.
- Affiliations
- Royal College of Surgeons in Ireland (IE)
- Corresponding author
- Galvin, R.
- Venue
- Family Practice
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-04-12
- Volume
- 28
- Issue
- 4
- Pages
- 366-376
- ISSN
- 0263-2136 (ISSN-L)
- 1460-2229
- OpenAlex
- W2169406903
- Cited by
- 30
- References
- 33
- Citations by year
- 2025: 2 · 2023: 2 · 2022: 2 · 2021: 4 · 2019: 1 · 2017: 2 · 2016: 1 · 2015: 4 · 2014: 4 · 2013: 4 · 2012: 4
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Family Practice (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Figshare (submittedVersion, cc-by-nc-nd)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- ABCD2, clinical prediction rules, transient ischemic attack, stroke risk prediction, risk stratification, rule validation
- MeSH terms
- Ischemic Attack, Transient, Humans, Predictive Value of Tests, Risk Factors, Time Factors, Risk Assessment, Stroke
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