title: Diagnostic accuracy of a simple clinical score to screen for vascular abnormalities in patients with intracerebral hemorrhage.
abstract: BACKGROUND
  Patients with intracerebral hemorrhage may have vascular abnormalities. There is no consensus about which patients should be studied with angiographic methods. Our aim was to derive a simple clinical score to screen for vascular abnormalities in intracerebral hemorrhage (ICH) and test its accuracy.
  
  
  METHODS
  The data were extracted from 2 different registries of patients with ICH. Variables associated with a vascular abnormality were studied in the derivation cohort. We derived a scale by assigning scores to the degree of association. We applied the score to the validation cohort and calculated sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios (LRs), receiver operating curves (ROC) and area under the curve (AUC).
  
  
  RESULTS
  The performance of the scale in the derivation cohort showed the maximum operating point (MOP) at ≥5 (sensitivity .77, specificity .5). In the validation cohort, the MOP was a cutoff point of ≥5 (sensitivity .76, specificity .467). The positive and negative LRs were 2.1 and .6, respectively. The ROC showed similar AUC for both cohorts: .7. The probability of a vascular malformation was 23% with scores ≤5 and 83% with scores ≥9 in the validation cohort.
  
  
  CONCLUSIONS
  This simple clinical score can be used immediately on diagnosing an ICH to decide accurately whether to perform an angiographic study or not. Further studies using this simple score should be used to validate it in larger prospective unselected cohorts and consecutive patients.
authors.affiliation: Vascular Neurology and Stroke Unit, Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Instituto de Neurociencias, Santiago, Chile; Department of Critical Care, Clínica Alemana de Santiago, Universidad del Desarrollo, Instituto de Neurociencias, Santiago, Chile.
authors.forename: Verónica V
authors.initials: VV
authors.lastname: Olavarría
authors.affiliation: Department of Neurological Sciences, Universidad de Chile, Hospital del Salvador, Santiago, Chile.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Bustamante
authors.affiliation: Vascular Neurology and Stroke Unit, Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Instituto de Neurociencias, Santiago, Chile; Department of Critical Care, Clínica Alemana de Santiago, Universidad del Desarrollo, Instituto de Neurociencias, Santiago, Chile.
authors.forename: Mirta Javiera
authors.initials: MJ
authors.lastname: López
authors.affiliation: Vascular Neurology and Stroke Unit, Neurology Service, Department of Medicine, Clínica Alemana de Santiago, Universidad del Desarrollo, Instituto de Neurociencias, Santiago, Chile; Department of Neurological Sciences, Universidad de Chile, Institute of Neurosurgery, Santiago, Chile. Electronic address: pablolavados@yahoo.com.
authors.forename: Pablo M
authors.initials: PM
authors.lastname: Lavados
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D012680:Sensitivity and Specificity; D054079:Vascular Malformations / Q000150:complications / Q000473:pathology*; D055815:Young Adult
keywords: Intracerebral hemorrhage; angiography; diagnostic criteria; vascular abnormality