A comparison of the 33-item Hypomania Checklist with the 33-item Hypomania Checklist-external assessment for the detection of bipolar disorder in adolescents

Abstract Background Adolescents with bipolar disorder (BD) are often misdiagnosed as having major depressive disorder (MDD), which delays appropriate treatment and leads to adverse outcomes. The aim of this study was to compare the performance of the 33-item Hypomania Checklist (HCL-33) with the 33-item Hypomania Checklist- external assessment (HCL-33-EA) in adolescents with BD or MDD. Methods 147 adolescents with BD and 113 adolescents with MDD were consecutively recruited. The HCL-33 and HCL-33-EA were completed by patients and their carers, respectively. The sensitivity, positive predictive value (PPV), specificity, negative predictive value (NPV), and area under the curve (AUC) were calculated and compared between the two instruments, using cut-off values based on the Youden’s index. Results The total scores of the HCL-33 and HCL-33-EA were positively and significantly correlated (rs = 0.309, P < 0.001). Compared to the HCL-33, the HCL-33-EA had higher sensitivity and NPV (HCL-33: sensitivity = 0.58, NPV = 0.53; HCL-33-EA: sensitivity = 0.81, NPV = 0.60), while the HCL-33 had higher specificity and PPV (HCL-33: specificity = 0.61, PPV = 0.66; HCL-33-EA: specificity = 0.37, PPV = 0.63). Conclusion Both the HCL-33 and HCL-33-EA seem to be useful for screening depressed adolescents for BD. The HCL-33-EA would be more appropriate for distinguishing BD from MDD in adolescents due to its high sensitivity in Chinese clinical settings.

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Comparing Screening Abilities of the 33-Item Hypomania Checklist (HCL-33) and the 33-Item Hypomania Checklist External Assessment (HCL-33-EA) for the Detection of Bipolar Disorder

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.518722 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yuan-Yuan Wang ◽

Yuan Feng ◽

Meng Fang ◽

Chengwei Guo ◽

Gabor S. Ungvari ◽

...

Keyword(s):

Bipolar Disorder ◽

Predictive Value ◽

Area Under The Curve ◽

Daily Practice ◽

Clinical Settings ◽

Major Depressive ◽

External Assessment ◽

Current Sample ◽

Sensitivity Specificity ◽

Youden’S Index

Background: Bipolar disorder (BD) is a severe psychiatric disorder that is often misdiagnosed and under-diagnosed in clinical settings. The 33-item Hypomania Checklist (HCL-33) is a newly developed self-administered scale for BD detection, while the 33-item Hypomania Checklist-external assessment (HCL-33-EA) is a version of the HCL-33 for external rating used by patient's carer (e.g., family member or friend). We aimed to compare the screening abilities between the HCL-33 and the HCL-33-EA, and evaluate the screening consistency between the two scales.Methods: The data were collected from 269 patients with diagnosed BD (n = 84) or major depressive disorder (MDD) (n = 185). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) between the HCL-33 and the HCL-33-EA for BD were compared against clinician diagnosis as the gold standard.Results: Using Youden's index, the optimal cut-off value of the HCL-33 is 20, while the corresponding figure for HCL-33-EA is 11. Using Youden's index, the HCL-33-EA showed a better performance than the HCL-33 (0.51 vs.0.41). The HCL-33-EA was more sensitive in correctly identifying BD patients from MDD patients than the HCL-33 (0.83 vs. 0.59), while the HCL-33 presented better specificity than the HCL-33-EA (0.82 vs. 0.68). There was significant screening consistency between the two scales (p < 0.001).Conclusions: Both scales have acceptable psychometric properties in detection BD from MDD. Use of the two scales should be considered based on the assessment purpose in clinical research or daily practice (i.e., prefer sensitivity or specificity). Noticeably, the current sample size is insufficient and future studies are recommended to further evaluate the scales.

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Recalibrating the Non-Communicable Diseases Risk Prediction Tools for the Rural Population of Western India

10.21203/rs.3.rs-657433/v1 ◽

2021 ◽

Author(s):

Manoj Kumar Gupta ◽

Pankaja Raghav ◽

Tooba Tanvir ◽

Vaishali Gautam ◽

Amit Mehto ◽

...

Keyword(s):

Risk Prediction ◽

Predictive Value ◽

Area Under The Curve ◽

Vascular Diseases ◽

High Sensitivity ◽

Roc Curves ◽

Risk Scores ◽

Western India ◽

Anthropometric Parameters ◽

Youden’S Index

Abstract Background: The present study was conducted to recalibrate the effectiveness of Indian Diabetes Risk Scores (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistically screening for Diabetes Mellitus (DM) and Hypertension (HT) among the patients attending health centres, and to estimate the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) using WHO/ISH chartMethods: All the people of age ≥30 years attending the health centers were screened for DM and HT. Weight, height, and waist and hip circumferences were measured and BMI and Waist Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden’s index were calculated for different cut-offs of IDRS and CBAC scores.Results: A total of 942 participants were included for the screening, out of them, 6.42 % (95% CI: 4.92-8.20) were diagnosed with DM. Hypertension was detected among 25.7% (95% CI: 22.9-28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score >4. As much as 26.1% were at moderate to higher risk (≥10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58-0.70), with 67.1% SN and 55.2% SP (Youden's Index= 0.22). While the AUC for CBAC was 0.59 (0.53-0.65). For hypertension the both the AUCs were 0.66 (0.62-0.71) and 0.63 (0.59-0.67), respectively.Conclusions: Instead of CBAC, the present study emphasizes the usefulness of IDRS as an excellent tool for screening for both DM and HT. This is the time to expose the hidden part of the NCDs iceberg by having high sensitivity of non-invasive instruments (like IDRS), so, we propose a cut-off value of 50 for the IDRS to screen for diabetes in the rural Indian population.

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Significance of CAVI, hs-CRP and Homocysteine in subclinical arteriosclerosis among a healthy population in China

Clinical & Investigative Medicine ◽

10.25011/cim.v36i2.19570 ◽

2013 ◽

Vol 36 (2) ◽

pp. 81 ◽

Cited By ~ 1

Author(s):

Jinpeng Zhong ◽

Yonghong Wang ◽

Xiaoling Wang ◽

Fengzeng Li ◽

Yulei Hou ◽

...

Keyword(s):

Predictive Value ◽

Area Under The Curve ◽

High Sensitivity ◽

Intima Media Thickness ◽

Roc Curves ◽

Carotid Intima Media Thickness ◽

Youden Index ◽

Healthy Population ◽

Hs Crp ◽

Sensitivity Specificity

Purpose: The purpose of this study is to evaluate the ability of cardio-ankle vascular index (CAVI), high-sensitivity C-reactive protein (hs-CRP) levels and homocysteine (Hcy) levels to screen for subclinical arteriosclerosis (subAs) in an apparently healthy population, with the view to obtaining an optimal diagnostic marker or profile for subAs. Methods: Subjects (152) undergoing routine health examinations were recruited and divided into two groups: carotid arteriosclerosis (CA) and non-carotid arteriosclerosis (NCA), according to carotid intima-media thickness (CMIT). CAVI was calculated based on blood pressure and pulse wave velocity. Serum hs-CRP and Hcy levels were also measured. A Receiver Operating Characteristic (ROC) curve was plotted to evaluate the efficacy of each in carotid arteriosclerosis screening. Ten parameter combinations, designated W1 to W10, were compared in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: The levels of all three parameters were significantly higher in the CA group, compared with the NCA group. ROC curves showed that the area under the curve (AUC) for CAVI was 0.708 (95%CI: 0.615-0.800), which is significantly larger than that of either hs-CRP (0.622) or Hcy (0.630), respectively (P < 0.001). Maximum sensitivity (100%) and NPV (100%) were attained with W10, while maximum specificity (86.2%) and PPV (46.7%) were obtained with W7. With W9, the maximum Youden index (0.416) was obtained, with a sensitivity of 77.8% and specificity of 63.8%. Conclusions: CAVI is more effective than hs-CRP or Hcy for subAs screening. The optimal profile was obtained with a combination of CAVI and other parameters.

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Performance of syndromic management for the detection and treatment of genitalChlamydia trachomatis,Neisseria gonorrhoeaeandTrichomonas vaginalisamong women attending antenatal, well woman and sexual health clinics in Papua New Guinea: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-018630 ◽

2017 ◽

Vol 7 (12) ◽

pp. e018630 ◽

Cited By ~ 13

Author(s):

Lisa M Vallely ◽

Pamela Toliman ◽

Claire Ryan ◽

Glennis Rai ◽

Johanna Wapling ◽

...

Keyword(s):

Sexual Health ◽

Papua New Guinea ◽

Predictive Value ◽

Lower Abdominal Pain ◽

High Sensitivity ◽

New Guinea ◽

Asia Pacific ◽

Clinical Settings ◽

Syndromic Management ◽

Low Sensitivity

ObjectivePapua New Guinea (PNG) has among the highest estimated prevalences of genitalChlamydia trachomatis(CT),Neisseria gonorrhoeae(NG) andTrichomonas vaginalis(TV) of any country in the Asia-Pacific region. Diagnosis and treatment of these infections have relied on the WHO-endorsed syndromic management strategy that uses clinical presentation without laboratory confirmation to make treatment decisions. We evaluated the performance of this strategy in clinical settings in PNG.DesignWomen attending antenatal (ANC), well woman (WWC) and sexual health (SHC) clinics in four provinces were invited to participate, completed a face-to-face interview and clinical examination, and provided genital specimens for laboratory testing. We estimated the performance characteristics of syndromic diagnoses against combined laboratory diagnoses.Results1764 women were enrolled (ANC=765; WWC=614; SHC=385). The prevalences of CT, NG and TV were highest among women attending ANC and SHC. Among antenatal women, syndromic diagnosis of sexually transmitted infection had low sensitivity (9%–21%) and positive predictive value (PPV) (7%–37%), but high specificity (76%–89%) and moderate negative predictive value (NPV) (55%–86%) for the combined endpoint of laboratory-confirmed CT, NG or TV. Among women attending WWC and SHC, ‘vaginal discharge syndrome’ had moderate to high sensitivity (72%–78%) and NPV (62%–94%), but low specificity (26%–33%) and PPV (8%–38%). ‘Lower abdominal pain syndrome’ had low sensitivity (26%–41%) and PPV (8%–23%) but moderate specificity (66%–68%) and high NPV (74%–93%) among women attending WWC, and moderate-high sensitivity (67%–79%) and NPV (62%–86%) but low specificity (26%–28%) and PPV (14%–33%) among SHC attendees.ConclusionThe performance of syndromic management for the detection and treatment of genital chlamydia, gonorrhoea and trichomonas was poor among women in different clinical settings in PNG. New diagnostic strategies are needed to control these infections and to prevent their adverse health outcomes in PNG and other high-burden countries.

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Time to step up 4 flights of stairs gives relevant information on exercise testing performance and results

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.196 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

JC Peteiro Vazquez ◽

A Bouzas-Mosquera ◽

C Rivadulla-Varela ◽

C Barbeito-Caamano ◽

JM Vazquez-Rodriguez

Keyword(s):

Exercise Capacity ◽

Exercise Testing ◽

Test Performance ◽

Predictive Value ◽

Area Under The Curve ◽

High Sensitivity ◽

High Specificity ◽

Cardiac Events ◽

Predictive Values ◽

Metabolic Equivalents

Abstract Funding Acknowledgements Type of funding sources: None. Background The achievement of a maximal workload of 10 metabolic equivalents (METs) is associated to good outcome with hard cardiac events of just around 1%/year. However, there is no much information on common daily exercises that can be quantitatively measured and give information about this exercise performance. We aimed to assess the capacity of stepping up stairs in patients submitted for an exercise testing (ExT). Methods A total of 165 consecutive ambulatory patients submitted for a clinically indicated ExT with ECG (ExT-ECG, n = 15) or echocardiography (ExT-E, n = 150) were included. At least 15 minutes after the test patients were asked to step up 4 flights of stairs (60 stairs) at fast pace without stopping but also without running and the time to do it was counted. Results Patients who achieved 10 METs during exercise (n = 69) made the stairs test in 46 ± 11 secs, those who achieved 8-10 METs (n = 37) in 58 ± 21 secs, and those who achieved <8 METs (n = 59) made it in 82 ± 41 secs (p < 0.001). Correlation between METs and stairs time test was 0.53 (Figure 1). The area under the curve ROC of stairs time for predicting an achievement of 10 METs was 0.79 (95% CI= 0.72-0.86, p < 0.001). A cut off value of 60 secs had high sensitivity (94%) and negative predictive value for 10 METs (93%) although specificity and positive predictive values were of 53% and 59%, respectively. A cut-off value of 90 secs had low sensitivity (34%) but high specificity (96%) and positive predictive value (83%) for predicting <8 METs. Abnormal results were seen in 58% of patients with limited exercise capacity, 30% with intermediate exercise capacity, and 29% with good exercise capacity (p = 0.002); and in 32% of patients that did the stairs test in at least 60 secs in comparison with 52% of those that lasted between 61-89 secs and 58% of those that lasted more (p = 0.018). Conclusions Most subjects able to step up 4 flights of stairs in 45 secs will perform well during exercise testing. On the contrary, those unable to make the stairs test in 1 and a half minutes are expected to have bad functional capacity and worse exercise test performance. Abstract Figure.

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Predicting asymptomatic neurosyphilis using peripheral blood indicators

BMC Infectious Diseases ◽

10.1186/s12879-021-06846-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weijie Li ◽

Jiaqi Han ◽

Pan Zhao ◽

Dagang Wang ◽

Tianhao Sun ◽

...

Keyword(s):

Infectious Disease ◽

Lumbar Puncture ◽

Peripheral Blood ◽

Predictive Value ◽

Area Under The Curve ◽

Youden’S Index ◽

Hiv Negative

Abstract Background The high misdiagnosis rate of asymptomatic neurosyphilis (ANS) has long challenged infectious disease clinicians. We aim to develop a model for diagnosing ANS in asymptomatic syphilis (AS) patients without CSF indicators. Results 277 AS patients with HIV-negative and underwent lumbar puncture were enrolled in this horizontal study.The area under the curve for predicting ANS by CSF leukocytes and protein was 0.643 and 0.675 [95% CI, 0.583–0.699VS.0.616–0.729]. Through LRM, the AUC increased to 0.806 [95% CI, 0.732–0.832], and the Youden's index was 0.430. If the score is ≤ 0.159, ANS can be excluded with a predictive value of 92.9%; we can identify ANS while the score is over 0.819, with a predictive value of 91.7% and a specificity of 99.25%. This study showed that the LRM can diagnose ANS in AS patients effectively. Conclusion Given a large number of misdiagnosis ANS patients and CSF results' insufficiency, the model is more practical. Our research will help clinicians track suspected syphilis, especially those who cannot accept the CSF test.

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Prognostic Accuracy of Mild Cognitive Impairment Subtypes at Different Cut-Off Levels

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000477341 ◽

2017 ◽

Vol 43 (5-6) ◽

pp. 330-341 ◽

Cited By ~ 11

Author(s):

Mattias Göthlin ◽

Marie Eckerström ◽

Sindre Rolstad ◽

Anders Wallin ◽

Arto Nordlund

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Predictive Value ◽

High Sensitivity ◽

Clinical Settings ◽

Prognostic Accuracy ◽

Dementia Syndrome ◽

Prognostic Utility ◽

Progressive Disorder

Background/Aims: The prognostic accuracy of mild cognitive impairment (MCI) in clinical settings is debated, variable across criteria, cut-offs, subtypes, and follow-up time. We aimed to estimate the prognostic accuracy of MCI and the MCI subtypes for dementia using three different cut-off levels. Methods: Memory clinic patients were followed for 2 (n = 317, age 63.7 ± 7.8) and 4-6 (n = 168, age 62.6 ± 7.4) years. We used 2.0, 1.5, and 1.0 standard deviations (SD) below the mean of normal controls (n = 120, age 64.1 ± 6.6) to categorize MCI and the MCI subtypes. Prognostic accuracy for dementia syndrome at follow-up was estimated. Results: Amnestic multi-domain MCI (aMCI-md) significantly predicted dementia under all conditions, most markedly when speed/attention, language, or executive function was impaired alongside memory. For aMCI-md, sensitivity increased and specificity decreased when the cut-off was lowered from 2.0 to 1.5 and 1.0 SD. Non-subtyped MCI had a high sensitivity and a low specificity. Conclusion: Our results suggest that aMCI-md is the only viable subtype for predicting dementia for both follow-up times. Lowering the cut-off decreases the positive predictive value and increases the negative predictive value of aMCI-md. The results are important for understanding the clinical prognostic utility of MCI, and MCI as a non-progressive disorder.

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Diagnostic validation of a high-sensitivity troponin I assay and its use in a guideline-consistent rapid diagnostic protocol

European Heart Journal ◽

10.1093/eurheartj/ehab724.1385 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

N A Soerensen ◽

A Gossling ◽

J T Neumann ◽

T S Hartikainen ◽

P M Haller ◽

...

Keyword(s):

Predictive Value ◽

Cardiac Troponin ◽

Diagnostic Performance ◽

Troponin I ◽

Area Under The Curve ◽

Diagnostic Algorithm ◽

High Sensitivity ◽

Final Diagnosis ◽

Esc Guidelines ◽

St Elevation

Abstract Background Current ESC guidelines on management of non-ST-elevation myocardial infarction (NSTEMI) recommend rapid diagnostic protocols using validated high-sensitivity cardiac troponin (hs-cTn) assays (1). While established protocols are available for several hs-cTn assays, data on the diagnostic performance of the Siemens Atellica IM High-Sensitivity Cardiac Troponin I assay is limited. Methods In a cohort study including 1,800 patients presenting with suspected acute MI. Final diagnosis of MI was adjudicated by two cardiologists separately in accordance with the fourth universal definition of MI (2). We developed and validated a 0/1h diagnostic algorithm using the Siemens Atellica assay. The algorithm was established in the first 928 patients and validated in the following 872 patients. Results ROC analyses for the diagnosis of NSTEMI revealed high discriminatory ability of the Siemens hs-cTnI assay with an area under the curve of 0.88 (95% confidence interval (CI): 0.86–0.90) at 0h, 0.93 (CI: 0.91–0.94) after 1h and 0.95 (CI: 0.93–0.96) after 3h (Figure 1). The derived algorithm consisted of a baseline rule-out of non-ST elevation MI using a cutoff <3 ng/L in patients with a symptom onset ≥3h or an admission troponin I <6 ng/L with a delta change from 0h to 1h <3 ng/L. For rule-in, an admission troponin I ≥120 ng/L or an increase within the first hour ≥12 ng/L was required. Application of the algorithm to the validation cohort showed a negative predictive value of 99.8% (CI 98.7%-100.0%), a sensitivity of 99.1% (CI 95.1%–100.0%) and 48.3% of patients ruled out, whereas 15.1% were ruled in with a positive predictive value of 68.0% (CI 59.1%-75.9%) and a specificity of 94.4% (92.5%–96.0%). The diagnostic performance was comparable to guideline-recommended application of an established hs-cTnI assay in a rapid 0/1h strategy (1). Conclusion The Siemens hs-cTnI assay is well-suited for application in rapid diagnostic stratification of patients with suspected MI and showed similar performance when compared with an established hs-cTnI assay using an algorithm recommended by recent ESC guidelines. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): German Heart foundation Figure 1

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The Chest Radiographic Thoracic Area Can Serve as a Prediction Marker for Morbidity and Mortality in Infants With Congenital Diaphragmatic Hernia

Frontiers in Pediatrics ◽

10.3389/fped.2021.740941 ◽

2021 ◽

Vol 9 ◽

Author(s):

Meike Weis ◽

Sosan Burhany ◽

Alba Perez Ortiz ◽

Oliver Nowak ◽

Svetlana Hetjens ◽

...

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Retrospective Cohort ◽

Area Under The Curve ◽

High Sensitivity ◽

Ecmo Support ◽

Morbidity And Mortality ◽

Fetal Ultrasonography ◽

Prediction Parameters ◽

Higher Sensitivity

Objective: Valid postnatal prediction parameters for neonates with congenital diaphragmatic hernia (CDH) are lacking, but recently, the chest radiographic thoracic area (CRTA) was proposed to predict survival with high sensitivity. Here, we evaluated whether the CRTA correlated with morbidity and mortality in neonates with CDH and was able to predict these with higher sensitivity and specificity than prenatal observed-to-expected (O/E) lung-to-head ratio (LHR).Methods: In this retrospective cohort study, all neonates with CDH admitted to our institution between 2013 and 2019 were included. The CRTA was measured using the software Horos (V. 3.3.5) and compared with O/E LHR diagnosed by fetal ultrasonography in relation to outcome parameters including survival, extracorporeal membrane oxygenation (ECMO) support, and chronic lung disease (CLD).Results: In this study 255 neonates were included with a survival to discharge of 84%, ECMO support in 46%, and 56% developing a CLD. Multiple regression analysis demonstrated that the CRTA correlates significantly with survival (p = 0.001), ECMO support (p < 0.0001), and development of CLD (p = 0.0193). The CRTA displayed a higher prognostic validity for survival [area under the curve (AUC) = 0.822], ECMO support (AUC = 0.802), and developing a CLD (AUC = 0.855) compared with the O/E LHR.Conclusions: Our data suggest that the postnatal CRTA might be a better prognostic parameter for morbidity and mortality than the prenatal O/E LHR.

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Evaluation of the clot burden score (cbs) for acute ischemic stroke (ais) in intent-to-treat patients.

Journal Of Cardiovascular, Neurovascular & Stroke ◽

10.32896/cvns.v1n1.11-15 ◽

2019 ◽

Vol 1 (1) ◽

pp. 11-15 ◽

Cited By ~ 1

Author(s):

Sarah Yaziz ◽

Ahmad Sobri Muda ◽

Wan Asyraf Wan Zaidi ◽

Nik Azuan Nik Ismail

Keyword(s):

Ischemic Stroke ◽

Clinical Outcome ◽

Acute Ischemic Stroke ◽

Predictive Value ◽

Area Under The Curve ◽

Rank Correlation ◽

Treatment Decision ◽

Roc Curves ◽

Significant Negative Correlation ◽

Clot Burden

Background : The clot burden score (CBS) is a scoring system used in acute ischemic stroke (AIS) to predict patient outcome and guide treatment decision. However, CBS is not routinely practiced in many institutions. This study aimed to investigate the feasibility of CBS as a relevant predictor of good clinical outcome in AIS cases. Methods: A retrospective data collection and review of AIS patients in a teaching hospital was done from June 2010 until June 2015. Patients were selected following the inclusion and exclusion criteria. These patients were followed up after 90 days of discharge. The Modified Rankin scale (mRS) was used to assess their outcome (functional status). Linear regression Spearman Rank correlation was performed between the CBS and mRS. The quality performance of the correlations was evaluated using Receiver operating characteristic (ROC) curves. Results: A total of 89 patients with AIS were analysed, 67.4% (n=60) male and 32.6% (n=29) female. Twenty-nine (29) patients (33.7%) had a CBS ?6, 6 patients (6.7%) had CBS <6, while 53 patients (59.6%) were deemed clot free. Ninety (90) days post insult, clinical assessment showed that 57 (67.6%) patients were functionally independent, 27 (30.3%) patients functionally dependent, and 5 (5.6%) patients were deceased. Data analysis reported a significant negative correlation (r= -0.611, p<0.001). ROC curves analysis showed an area under the curve of 0.81 at the cut-off point of 6.5. This showed that a CBS of more than 6 predicted a good mRS clinical outcome in AIS patients; with sensitivity of 98.2%, specificity of 53.1%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 21%. Conclusion: CBS is a useful additional variable for the management of AIS cases, and should be incorporated into the routine radiological reporting for acute ischemic stroke (AIS) cases.

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