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.