Dizzy & You Missed A Stroke

HINTS? STANDING? Or the Sudbury Vertigo Risk Score?

If you blinked and missed the first publication highlighting the “Sudbury Vertigo Risk Score”, you wouldn’t be alone. But, you’d have outed yourself as someone who didn’t listen to the Annals of Emergency Medicine podcast!

At the conclusion of our review, we say: well, wouldn’t it be nice if this tool were validated.

This is that next publication.

First, to refresh your memory:

Second, their results – as derived from a retrospective cohort of 4500 patients, 100 of whom had serious outcomes:

The cut-point proposed is <5, giving sensitivity for a serious diagnosis of 100% (95% CI 96.5%–100%) and a specificity of 69.2% (95% CI 67.8%–70.51%).

Naturally, these are all derived off a population without bulletproof outcomes assessment, so “100% sensitivity” cannot be guaranteed. Then, the outcomes of interest don’t truly start to enrich until around a score of 7 or 8 – and, even there, the probabilities of adverse outcomes remain very low.

This is a nice general verification of the initial paper, but not the implementation science needed for generalizable deployment.