Dutta developed the DOT score (Diagnosis of TIA) score for making the diagnosis of transient ischemic attack (TIA). The author is from Gloucestershire Royal Hospital in England.
Patient selection: adult at risk for TIA
Parameters:
(1) age in years
(2) history of hypertension
(3) atrial fibrillation (history of or new or paroxysmal)
(4) dysphasia (disorder of language)
(5) unilateral facial weakness
(6) unilateral arm and/or leg weakness
(7) diplopia
(8) visual aura (fortification spectra, scintillation, spreading scotoma)
(9) unilateral sensory loss
(10) ataxia of limb or gait
(11) headache
(12) amnesia
(13) loss of consciousness or pre-syncope
(14) tingling, numbness, pins and needles
(15) visual loss
(15A) monocular visual loss
(15B) bilateral visual loss
(15C) homonymous hemianopia (loss of either left or right visual field)
|
Parameter |
Finding |
Regression Coefficient |
|
age in years |
|
0.02 * |
|
history of hypertension |
no |
0 |
|
|
yes |
0.32 |
|
atrial fibrillation |
no |
0 |
|
|
yes |
0.62 |
|
dysphasia |
no |
0 |
|
|
yes |
3.13 |
|
unilateral facial weakness |
no |
0 |
|
|
yes |
1.69 |
|
unilateral arm and/or leg weakness |
no |
0 |
|
|
yes |
3.15 |
|
diplopia |
no |
0 |
|
|
yes |
2.14 |
|
visual aura |
no |
0 |
|
|
yes |
-1.84 |
|
unilateral sensory loss |
no |
0 |
|
|
yes |
2.11 |
|
ataxia |
no |
0 |
|
|
yes |
2.06 |
|
headache |
no |
0 |
|
|
yes |
-0.66 |
|
amnesia |
no |
0 |
|
|
yes |
-1.70 |
|
loss of consciousness or pre-syncope |
no |
0 |
|
|
yes |
-0.78 |
|
tingling, numbness. pins and needles |
no |
0 |
|
|
yes |
-0.80 |
|
visual loss |
none |
0 |
|
|
monocular |
3.58 |
|
|
bilateral |
1.83 |
|
|
homonymous hemianopia |
3.25 |
where:
• The handling of visual loss is not exactly clear. The various types of visual loss appear to be mutually exclusive.
X =
= SUM(regression coefficients) - 3.365
probability of TIA =
= 1 / (1 + EXP((-1) * X))
Limitations:
• The score is intended for research purposes and has not been externally validated.
Specialty: Neurology
