Introduction

Each year, half a million patients present to emergency departments in the US with acute vestibular syndrome (AVS) characterized by vertigo lasting more than 24 hours. Though this is frequently caused by something benign such as a self-limited viral infection, it may also indicate a more severe condition such as stroke of the posterior circulation. Unfortunately, MRI can miss strokes when obtained early in the disease course meaning half of those with with posterior strokes are inappropriately sent home from the ER.

Solution

Three physical exam maneuvers have been together validated that allow clinicians to reliably diagnose posterior circulation strokes. The Stroke in AVS app instructs clinicians at the point of care to review the steps to performing these three maneuvers and calculates the probability that the patient is having a stroke thereby reducing misdiagnosis.

Challenges

• Design a point-of-care instructional interface including video
• Incorporate Bayesian statistics to create a probability of patient having a stroke

More about the app here or you can see the SMART Apps for Health Challenge submission.