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Good Positive and Negative Likelihood Ratios

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Neurocardiogenic Syncope: Likelihood Ratios

Introduction:

Versus Ischemic Stroke. See also Subarachnoid Hemorrhage which shares some of the same findings (i.e. when intraparenchymal blood crosses into the subarachnoid space).

Great review of many findings (not all listed here): JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

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Tags: Cardiac Problem Neurologic Tag this Diagnosis.

Differential Diagnoses include: Stroke, Syncope

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Patients with syncope 33% J Am Coll Cardiol 2001 Jun 1;37(7):1921-8. PMID 11401133
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The likelihood ratios of findings for Neurocardiogenic Syncope 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.)
Good Positive and Negative Likelihood Ratios
FindingResult +LR-LR
[ + ] Xanthochromia + 0 - 14.20.3
[ + ] Clinical diagnosis + 0 - 6.30.3
Good Negative Likelihood Ratio
FindingResult +LR-LR
[ + ] Tilt Table Test + 0 - 1.70.5
Good Positive Likelihood Ratio
FindingResult +LR-LR
[ + ] Kernig or Brudzinski Sign + 0 - 7.50.9
[ + ] Neck Stiffness + 0 - 6.70.8
[ + ] Coma + 0 - 5.80.7
[ + ] Seizure + 0 - 4.50.9
[ + ] Hypertension + 0 - 4.40.6
[ + ] Headache + 0 - 2.60.7
Negative Findings
FindingResult +LR-LR
[ + ] Carotid Bruit + 0 - 0.11.1
[ + ] Atrial Fibrillation + 0 - 0.11.2
[ + ] Alert + 0 - 0.32.5
[ + ] Prior TIA + 0 - 0.31.2
Poorly Diagnostic Findings
FindingResult +LR-LR
[ + ] Acute Onset + 0 - 0.61.8