False positive rapid antigen tests for SARS-CoV-2 in the real-world and their economic burden

Background: The Colorado Stroke Advisory Board (COSAB) asked three Joint Commission (JC) comprehensive stroke centers (CSC) and one primary stroke center (PSC) to assist with determining the usefulness of the Cincinnati Pre-Hospital Stroke Severity Score (CPSSS) in predicting large vessel occlusion (LVO) in patients with acute stroke symptoms. Purpose: The purpose of the study was to determine the real world applicability of the CPSSS in predicting LVO. Methods: CPSSS and LVO data was collected by stroke coordinators at three CSCs and one PSC for all patients brought to their respective emergency departments via local emergency medical services (EMS) from June 2016 to July 2016 as stroke alerts. The CPSSS was calculated retrospectively using the initial documented neurological exam and LVO was determined by initial computed tomography (CT) imaging results or physician notes in the electronic medical record. Results: Our study included 235 patients that were brought to 4 certified stroke centers in the Denver metropolitan area during a two month period in 2016. Eighty percent of patients (N=187/235) correctly screened negative on the CPSSS. Ten percent (N=23/235) of patients screened positive and were later determined to have LVO based on initial imaging. Four patients went on for endovascular treatment at a CSC that initially screened negative using the CPSSS. Nine percent (N=21/235) of patients screened false-positive for LVO. Top reasons for false positive CPSSS include intracerebral hemorrhage, altered mental status, seizure, and brain stem stroke. Conclusion: CPSSS is a reasonable screening tool to assess for LVO. More study is recommended to determine how to avoid missing LVO in stroke patients with mild symptoms on initial presentation.

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Evaluating Mental Health Services; How Do Programs for Children “Work” in the Real World? Edited by Carol T. Nixon & Denine A. Northrup. Sage, Thousand Oaks CA, 1997. pp. 306. £16.60 (pb).

Journal of Child Psychology and Psychiatry ◽

10.1017/s0021963098222918 ◽

1998 ◽

Vol 39 (6) ◽

pp. 935-936

Author(s):

Anne Worrall-Davies

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Real World ◽

The Real

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Current Issues: Evidence-Based Practice for the Real World: Thoughts on Clinical Education in Communication Disorders

Perspectives on Administration and Supervision ◽

10.1044/aas20.3.100 ◽

2010 ◽

Vol 20 (3) ◽

pp. 100-105 ◽

Cited By ~ 3

Author(s):

Anne K. Bothe

Keyword(s):

Clinical Education ◽

Real World ◽

Evidence Based Practice ◽

Communication Disorders ◽

University Faculty ◽

Evidence Based ◽

Speech Language Pathology ◽

Basic Principles ◽

The Real ◽

Language Pathology

This article presents some streamlined and intentionally oversimplified ideas about educating future communication disorders professionals to use some of the most basic principles of evidence-based practice. Working from a popular five-step approach, modifications are suggested that may make the ideas more accessible, and therefore more useful, for university faculty, other supervisors, and future professionals in speech-language pathology, audiology, and related fields.

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