Table 3

Roles of the ABCD2 proforma with exemplar quotes

1.Might generate medicolegal threat“You might have to justify in the future why you haven't followed a guideline” (901, Cambridgeshire GP)
2.Demonstrates need for urgency to patient“ it sometimes provokes a little bit of alarm” (701, Cambridgeshire GP)
3.Educates the patient“when things have sometimes had the hospital stamp of approval, it's easier to explain things, so they see a clear-cut pathway basically” (702, Cambridgeshire GP)
4.Diagnostic tool“you've got the tick box, it helps define what is a TIA and that score thing is very helpful” (605, Birmingham GP)
5.Prognostic tool“a lower score makes it okay to send it to the next TIA clinic and a higher score you send it urgently” (702, Cambridgeshire GP)
6.Demonstrates need for urgency to the GP“It didn't feel right to send somebody to hospital very urgently who seems perfectly alright… Having the score there sort of gives you a bit of confidence to do just that” (703, Cambridgeshire GP)
7.Facilitates smoother patient pathway“It's just simpler because we know what they need and it's a way of getting it” (610, Birmingham GP)
8.Educates/reminds the GP what to do“I usually dig it out if I'm thinking to refer somebody to that clinic just to remind myself… it's always useful to have something in front of you” (605, Birmingham GP)
9.Distils a complex history“you simply go ‘Okay, you fit a number, you need to go in, we need to refer you, there's a degree of urgency” (701, Cambridgeshire GP)
10.Obscures a complex history“You get an idea from the actual GP, the history and what the patient's told you more than you can from the score really” (606, specialist nurse)
11.Misleading GPs about diagnosis“If you start from the right places, that this was a TIA, it's fine, but as I say, just because you're 80, you've got diabetes and hypertension, you automatically score three… so it has no diagnostic value, the ABCD2 score” (711, consultant)
12.Prevents inappropriate referrals“Some GPs lie to get them into clinic. Not so much now that we've changed the pro forma” (710, specialist nurse)
13.Barrier to appropriate care“Our vision… would be to have a TIA hotline… and using that system I wouldn't bother using the ABCD2 score” (602, consultant)
  • GP, general practitioner; TIA,transient ischaemic attack.