title: ASTRAL, DRAGON and SEDAN scores predict stroke outcome more accurately than physicians.
abstract: ASTRAL, SEDAN and DRAGON scores are three well-validated scores for stroke outcome prediction. Whether these scores predict stroke outcome more accurately compared with physicians interested in stroke was investigated.
  
  
  
  Physicians interested in stroke were invited to an online anonymous survey to provide outcome estimates in randomly allocated structured scenarios of recent real-life stroke patients. Their estimates were compared to scores' predictions in the same scenarios. An estimate was considered accurate if it was within 95% confidence intervals of actual outcome.
  
  
  
  In all, 244 participants from 32 different countries responded assessing 720 real scenarios and 2636 outcomes. The majority of physicians' estimates were inaccurate (1422/2636, 53.9%). 400 (56.8%) of physicians' estimates about the percentage probability of 3-month modified Rankin score (mRS) > 2 were accurate compared with 609 (86.5%) of ASTRAL score estimates (P < 0.0001). 394 (61.2%) of physicians' estimates about the percentage probability of post-thrombolysis symptomatic intracranial haemorrhage were accurate compared with 583 (90.5%) of SEDAN score estimates (P < 0.0001). 160 (24.8%) of physicians' estimates about post-thrombolysis 3-month percentage probability of mRS 0-2 were accurate compared with 240 (37.3%) DRAGON score estimates (P < 0.0001). 260 (40.4%) of physicians' estimates about the percentage probability of post-thrombolysis mRS 5-6 were accurate compared with 518 (80.4%) DRAGON score estimates (P < 0.0001).
  
  
  
  ASTRAL, DRAGON and SEDAN scores predict outcome of acute ischaemic stroke patients with higher accuracy compared to physicians interested in stroke.
authors.affiliation: Department of Medicine, University of Thessaly, Larissa, Greece. gntaios@med.uth.gr.
authors.forename: G
authors.initials: G
authors.lastname: Ntaios
authors.affiliation: Sub-directorate of Informatics, Larissa General University Hospital, Larissa, Greece.
authors.forename: F
authors.initials: F
authors.lastname: Gioulekas
authors.affiliation: Department of Neurosciences, Stroke Service, Leeds Teaching Hospitals NHS Trust and School of Medicine, University of Leeds, Leeds, UK.
authors.forename: V
authors.initials: V
authors.lastname: Papavasileiou
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: D
authors.identifier: 0000-0001-9095-2344
authors.initials: D
authors.lastname: Strbian
authors.affiliation: Stroke Centre, Neurology Service, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Michel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011379:Prognosis; D020521:Stroke / Q000175:diagnosis*
keywords: 
  ASTRAL
  ; 
  DRAGON
  ; 
  SEDAN
  