The sensitivity of a diagnostic test is ideally calculated by comparing the test assessments
to a truth determined by another (perfect) test considered to be the gold standard.
However, in many cases, there is no perfect gold standard.
1
When it exists, assessment by the gold standard can be inaccessible, costly, or highly
invasive. Using the best available but imperfect diagnostic test as gold standard
can lead to substantial error in the estimation of diagnostic accuracy.
1
The detection of atrial fibrillation (AF) after ischemic stroke is not an exception
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References
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- Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis.Lancet Neurol. 2015; 14: 377-387
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- Very short paroxysms account for more than half of the cases of atrial fibrillation detected after stroke and TIA: a systematic review and meta-analysis.Int J Stroke. 2015; 10: 801-807
- Clinically important atrial arrhythmia and stroke risk: a UK-wide online survey among stroke physicians and cardiologists.QJM. 2014; 107: 895-902
- Performance of a new leadless implantable cardiac monitor in detecting and quantifying atrial fibrillation: results of the XPECT trial.Circ Arrhythm Electrophysiol. 2010; 3: 141-147
- Poststroke atrial fibrillation: cause or consequence? Critical review of current views.Neurology. 2014; 82: 1180-1186
Article Info
Publication History
Published online: November 11, 2015
Received:
October 25,
2015
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- A Comparison of Atrial Fibrillation Monitoring Strategies After Cryptogenic Stroke (from the Cryptogenic Stroke and Underlying AF Trial)American Journal of CardiologyVol. 116Issue 6
- PreviewIschemic stroke cause remains undetermined in 30% of cases, leading to a diagnosis of cryptogenic stroke. Paroxysmal atrial fibrillation (AF) is a major cause of ischemic stroke but may go undetected with short periods of ECG monitoring. The Cryptogenic Stroke and Underlying Atrial Fibrillation trial (CRYSTAL AF) demonstrated that long-term electrocardiographic monitoring with insertable cardiac monitors (ICM) is superior to conventional follow-up in detecting AF in the population with cryptogenic stroke.
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