Effect of Clinical History on Interpretation of Computed Tomography for Acute Stroke

Objective:We assessed whether providing detailed clinical information alongside computed tomography (CT) images improves their interpretation for acute stroke.Methods:Using the prospective Cornell AcutE Stroke Academic Registry, we randomly selected 100 patients who underwent noncontrast head CT within 6 hours of transient ischemic attack or minor acute ischemic stroke and underwent magnetic resonance imaging (MRI) within 6 hours of the CT. Three radiologist investigators evaluated each of the 100 CT studies twice, once with and once without accompanying information on medical history, signs, and symptoms. In random sequence, each study was interpreted in one condition (ie, with or without detailed accompanying information) and then after a 4-week washout period, in the opposite condition. Using MRI diffusion-weighted imaging (DWI) as the reference standard, we classified CT interpretations as correct (true positives or negatives) or incorrect (false positives or negatives). We used logistic regression wi...