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Subarachnoid Hemorrhage: Sensitivity and Specificity

Introduction: For a decision rule to screen patients with acute headache, see BMJ. 2010 Oct 28;341:c5204. PMID: 21030443 .

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Tags: Neurologic Psychiatric Pulmonary testicular Toxic Trauma Vascular Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Headaches in the emergency department 1% http://sinaiem.wordpress.com/2007/05/07/sah-update-are-new-ct-scanners-good-enough-to-obviate-the-lp/
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The sensitivity and specificity of findings for Subarachnoid Hemorrhage are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
**Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
Sensitive and Specific Findings
FindingResult SensitivitySpecificity
[ + ] Non-contrast Head CT + 0 - 92%100%
[ + ] CSF RBCs + 0 - 91%85%
Specific Findings
FindingResult SensitivitySpecificity
[ + ] Paralysis + 0 - 13%97%
[ + ] Loss of Consciousness + 0 - 18%96%
[ + ] Photophobia + 0 - 9%96%
[ + ] Altered Mental Status + 0 - 17%91%
[ + ] Neck Stiffness + 0 - 61%90%
Sensitive Findings
FindingResult SensitivitySpecificity
[ + ] Lack of Scotoma + 0 - 100%7%
[ + ] Headache Location + 0 - 96%29%
[ + ] Headache Quality + 0 - 96%25%
[ + ] Xanthochromia Sensitivity = 89%
[ + ] Non-contrast Head CT Sensitivity = 85%
Poorly Diagnostic Findings
FindingResult SensitivitySpecificity
[ + ] Onset During Exercise + 0 - 40%65%
[ + ] Headache Location + 0 - 57%62%
[ + ] Headache Quality + 0 - 62%53%
[ + ] Worst Headache + 0 - 83%36%
[ + ] No History of Migraine + 0 - 79%27%
[ + ] Xanthochromia Sensitivity = 65%
[ + ] Xanthochromia Sensitivity = 57%
[ + ] Non-contrast Head CT Sensitivity = 50%

 

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