Search bioRxiv⌕ Search
Home/Archive/bioRxiv

bioRxiv · 10.1101/089227

Development of a multivariate clinical prediction model for the diagnosis of mild stroke/TIA in physician first-contact patient settings

Bibok, M. B.·Penn, A. M.·Lesperance, M. L.·Votova, K.·Balshaw, R.
View original source ↗Export metadata ↓

Abstract

OBJECTIVETo develop a clinical prediction model for diagnosing mild stroke/transient ischemic attack (TIA) in first-contact patient settings. DESIGN: Retrospective study design utilizing logistic regression modeling of patient clinical symptoms collected from patient chart histories and referral data. SETTING: Regional fast-track TIA clinic on Vancouver Island, Canada, accepting referrals from emergency departments (ED) and general practice (GP). PARTICIPANTS: Model development: 4187 ED and GP referred patients from 2008-2011 who were assessed at the TIA clinic. Temporal hold-out validation: 1953 ED and GP referred patients from 2012-2013 assessed at the same clinic. OUTCOMES: Diagnosis of mild stroke/TIA by clinic neurologists. RESULTS: 123 candidate predictors were assessed using univariate feature selection for inclusion in the model, and culminated in the selection of 50 clinical features. Post-hoc investigation of the selected predictors revealed 12 clinically relevant interaction terms. Model performance on the temporal hold-out validation set achieved a sensitivity/specificity of 71.8% / 72.8% using the ROC01 cutpoint ([≥] 0.662), and an AUC of 79.9% (95% CI, 77.9%-81.9%). In comparison, the ABCD2 score ([≥] 4) achieved a sensitivity/specificity of 70.4% / 54.5% and an AUC of 67.5% (95% CI, 65.2%-69.9%). The logistic regression model demonstrated good calibration on the hold-out set ({beta}0 = -0.257); {beta}linear = 1.047).\n\nCONCLUSIONSThe developed diagnostic model performs better than the ABCD2 score at diagnosing mild stroke/TIA on the basis of clinical symptoms. The model has the potential to replace the use of the prognostic ABCD2 score in diagnostic medical contexts in which the ABCD2 score is currently used, such as patient triage.

Explore related subjects

bioinformaticsPreprint

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Bibok, M. B., Penn, A. M., Lesperance, M. L., Votova, K., Balshaw, R.. 2016-11-22. Development of a multivariate clinical prediction model for the diagnosis of mild stroke/TIA in physician first-contact patient settings. https://doi.org/10.1101/089227

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related preprints

bioRxiv2026

RoDPAA: A Robust Dissimilarity-Based Principal Angle Analysis Framework for Multi-View Microbiome Data Integration

Multiview microbiome studies profile the same participants across body sites or molecular layers, but integration is hampered by sparse, compositional data, modest sample sizes and methods that recognize only exact sharing. We present RoDPAA (Robust Dissimilarity-based Principal Angle Analysis), a framework that represents each view through any data-appropriate dissimilarity, such as Bray--Curtis, without log-ratio transformation or likelihood assumptions. RoDPAA aligns view-specific signal subspaces through principal angles, captures complete and partial sharing, and tests by permutation how many components are shared, using only eigendecomposition and little tuning. In Gaussian simulations, RoDPAA matched JIVE and MOFA given true ranks, ran faster and alone recovered the shared dimension in every replicate. In two inflammatory bowel disease (IBD) cohorts with sparse, zero-inflated data, Bray--Curtis-based RoDPAA recovered shared structure that was stable to prevalence filtering, whereas log-ratio-based alternatives were not. Its leading microbiome--metabolome factors, learned without disease labels, were the only ones associated with IBD.

bioinformatics↗
bioRxiv2026

Deducing splicing events from transcript sets with splicelogic

Long-read RNA sequencing captures a greater proportion of full-length transcripts, enabling more accurate isoform identification, discovery of novel isoforms, and more precise differential transcript usage analysis. However, comparing transcripts, whether between conditions or between sets such as novel and annotated isoforms, yields complex isoform changes that are hard to manipulate, summarize, and visualize. This is compounded by vertical integration of some tools, where downstream analysis depends on the specific output of a particular upstream tool. To address this gap, we have developed splicelogic, an R/Bioconductor package that makes transcript-set comparisons biologically interpretable by turning them into discrete splicing events, such as exon skipping, alternative splice sites, intron retention, and alternative transcription start and end sites. We designed splicelogic to integrate easily with existing RNA-seq workflows and tools. The splicelogic functions are modular, readable, and extensible, making it easy for users to adapt core logic to their own custom scientific questions or novel splicing definitions. By obtaining interpretable splicing events from transcript changes, splicelogic enables downstream analyses, including annotation of RNA-binding protein recognition sites, alongside summary statistics and visualization. The splicelogic package is publicly available and distributed through Bioconductor.

bioinformatics↗
bioRxiv2026

Contrastive Learning Improves Generalization on M2OR Olfactory Binding Dataset

Olfaction-based biosensors stand to have profound impacts in fields such as medical diagnostics, national security, and drug discovery. A promising mode of vapor phase biodetection mimics volatile organic compound-olfactory receptor (VOC-OR) interactions with target-specific protein or peptide probes; however, lack of experimental coverage remains a core bottleneck. Current computational approaches aim to improve prediction of VOC-OR binding to reduce experimental burden, and current machine learning approaches fail to demonstrate a level of generalization that addresses current engineering challenges. Here, using the Molecular to Olfactory Dataset (M2OR) and Insect Olfactory Binding Protein Database (iOBPdb) datasets, data partitioning methods and their performance are evaluated on a neural network and contrastive learning framework on such VOC-OR binding datasets, varying: model training, architecture, and structure of the input data distribution. It was found that holding out certain chemical or proteomic motifs from the training data diminished model performance with a two layer neural network model. The model was able to generalize to state of the art performance (0.88 AUCROC) on every data split by applying a contrastive learning objective defined by shared molecular constituents and a stochastic sampler. This suggests the contrastive objective provides a strong inductive bias for neural networks to predict novel VOC-OR pairs. These findings highlight that model performance on pairwise biological interaction datasets can be inflated through identity leakage from constituent overlap, and emphasize the need for more robust evaluation protocols. Furthermore, we show contrastive regularization mitigates dataset degeneracy through enforcement of compatibility in the models latent geometry that may extend to other binder target-datasets where identity leakage confounds evaluation.

bioinformatics↗