AUTHOR=Yuan Junliang , Jia Zejin , Song Yangguang , Hu Wenli 

TITLE=External Validation of the Diagnosis of TIA (DOT) Score for Identification of TIA in a Chinese Population

JOURNAL=Frontiers in Neurology

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.00796

DOI=10.3389/fneur.2019.00796

ISSN=1664-2295

ABSTRACT=Background: Recently, the [diagnosis of transient ischemic attack (TIA), DOT] score has been recognized to be a new tool for non-specialists to diagnose TIA more accurately with the sensitivity and specificity were 89% and 76%, respectively. However, the DOT score has not yet been validated externally in patients with TIA in China.
Methods: We retrospectively enrolled consecutive 500 patients with transient neurological symptoms, who were admitted to the Department of Neurology, Beijing Chaoyang Hospital and underwent magnetic resonance imaging (MRI) between Jan 2016 and Dec 2018. Patients with transient neurological symptoms were divided into two subgroups: TIA mimic group (N=140, 28%) and definite cerebrovascular events group including tissue-based TIA (DWI negative, N=252, 50.4%) and minor stroke (DWI positive, N=108, 21.6%). The demographic data, clinical characteristics, laboratory findings and scores of Dawson and DOT were compared between the two groups.  
Results: A total of 500 patients with transient neurological symptoms (mean age, 61.1±12.8) were enrolled and 70% (N=350) were male. Comparing with TIA mimic groups, patients with cerebrovascular events group were more likely to be higher diastolic blood pressure, uric acid and homocysteine, more motor weakness and speech abnormalities, higher scores of Dawson and DOT. The score of DOT showed the area under the curve (AUC=0.728), with a sensitivity of 70.3% and specificity of 62.9%, respectively. 
Conclusion: In patients with transient neurological symptoms, our findings showed DOT score performed relatively good calibration and discrimination to identify of TIA in a Chinese Population. As a novel tool of TIA identification, further validations are needed in multiple centers with large samples in China.