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The LIMIT-NI CDI Reduces Neuroimaging Vs. Unstructured Clinician Judgement in Recurrent Seizure Patients

admin by admin
November 8, 2022
in News


Neuroimaging for individuals with recurrent seizures was safely reduced in 2021 with the release of the LIMIT clinical decision instrument (CDI). The LIMIT CDI lowered neuroimaging by 13.3% and had a sensitivity of 90% and a negative predictive value of >99.9%. However, the original LIMIT CDI was difficult to use because of its design. Therefore, for a study, researchers sought to evaluate the LIMIT-NeuroImaging (LIMIT-NI) CDI’s performance in comparison to the original LIMIT CDI and to validate it.

The research involved individuals who presented to 3 emergency rooms with recurrent seizures. To all patients, the LIMIT-NI CDI was applied. In addition, they computed the LIMIT-NI CDI’s test features and contrasted them with unstructured clinical judgment.

Over 2,125 of the 3,401 patients who passed the final analysis were tested. Sixteen patients (0.75%) had positive CT results; all 16 patients were recognized with 100% sensitivity and 100% negative predictive value by the LIMIT-NI CDI and clinical judgment. Emergency care clinicians requested 835 brain CT scans using unstructured clinical judgment, compared to 499 scans if the CDI had been used. It was a reduction of 15.8% (relative reduction of 40.2%).

Comparing the LIMIT-NI CDI to the original LIMIT CDI, the LIMIT-NI CDI showed superior test characteristics and greater simplicity of application. The LIMIT-NI CDI reduced neuroimaging by 15.8% (relative reduction of 40.2%) in individuals with recurrent seizures compared to unstructured clinical judgment. Physicians can use the LIMIT-NI CDI in conjunction with their clinical judgment to limit neuroimaging in patients with recurrent seizures.

Reference: sciencedirect.com/science/article/pii/S0735675722006027



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