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Urgent referral for suspected CNS cancer: which clinical features are associated with a positive predictive value of 3 % or more?

Overview of attention for article published in BMC Neurology, August 2016
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  • Good Attention Score compared to outputs of the same age (65th percentile)

Mentioned by

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5 tweeters

Citations

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2 Dimensions

Readers on

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21 Mendeley
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Title
Urgent referral for suspected CNS cancer: which clinical features are associated with a positive predictive value of 3 % or more?
Published in
BMC Neurology, August 2016
DOI 10.1186/s12883-016-0677-1
Pubmed ID
Authors

Hasan Raza Mohammad, Jeremy Boardman, Laura Howell, Roger J. Mills, Hedley C. A. Emsley

Abstract

Urgent referral for suspected central nervous system (CNS) cancer is recommended, but little analysis of the referral criteria diagnostic performance has been conducted. New 2015 NICE guidance recommends direct brain imaging for patients with symptoms with positive predictive values (PPV) of 3 %, but further guidance is needed. A 12-month retrospective evaluation of 393 patients referred under previous 2005 NICE 2-week rule criteria was conducted. Analysis was based on the three groups of symptoms forming the referral criteria, (1) CNS symptoms, (2) recent onset headaches, (3) rapidly progressive subacute focal deficit/cognitive/behavioural/personality change. Comparison was made with neuroimaging findings. Twelve (3.1 %) of 383 patients who attended clinic had CNS cancer suggesting the combination of clinical judgement and application of 2005 criteria matched the 2015 guideline's PPV threshold. PPVs for the three groups of symptoms were (1) 4.1 % (95 % CIs 2.0 to 7.4 %), (2) 1.2 % (0.1 to 4.3 %) and (3) 3.7 % (0.1 to 19.0 %). Sensitivities were (1) 83.3 % (95 % CIs 51.6 to 97.9 %), (2) 16.7 % (2.1 to 48.4 %), and (3) 8.3 % (0.2 to 38.5 %); specificities were (1) 37.2 % (32.3 to 42.3 %), (2) 55.5 % (50.3 to 60.7 %) and (3) 93.0 % (89.9 to 95.4 %). Of 288 patients who underwent neuroimaging, 59 (20.5 %) had incidental findings, most commonly cerebrovascular disease. The 2015 guidance is less prescriptive than previous criteria making clinical judgement more important. CNS symptoms had greatest sensitivity, while PPVs for CNS symptoms and rapidly progressive subacute deficit/cognitive/behavioural/personality change were closest to 3 %. Recent onset headaches had the lowest sensitivity and PPV.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 21 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 3 14%
Lecturer > Senior Lecturer 2 10%
Professor 2 10%
Student > Doctoral Student 2 10%
Other 2 10%
Other 5 24%
Unknown 5 24%
Readers by discipline Count As %
Medicine and Dentistry 5 24%
Nursing and Health Professions 4 19%
Psychology 1 5%
Computer Science 1 5%
Social Sciences 1 5%
Other 2 10%
Unknown 7 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 April 2019.
All research outputs
#4,666,188
of 15,184,610 outputs
Outputs from BMC Neurology
#544
of 1,724 outputs
Outputs of similar age
#89,334
of 263,703 outputs
Outputs of similar age from BMC Neurology
#1
of 1 outputs
Altmetric has tracked 15,184,610 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 1,724 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.9. This one has gotten more attention than average, scoring higher than 68% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 263,703 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them