Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
To the Editor In their recent study, Dr Perry and colleagues1 addressed the challenging problem of misdiagnosis of subarachnoid hemorrhage. Perry et al1 reported 100% sensitivity for detecting subarachnoid hemorrhage, using the new Ottawa subarachnoid hemorrhage rule (OSHR). Despite this finding, 3 of the 6 characteristics in the rule showed only modest reliability (κ<0.60) among physicians. Limited flexion, thunderclap headache, and neck pain and stiffness were prevalent in subarachnoid hemorrhage, and the OSHR required that only 1 needed to be present for further investigation to be warranted.
Specogna AV. Subarachnoid Hemorrhage Diagnosis. JAMA. 2014;311(2):201. doi:10.1001/jama.2013.284318