Work

Diagnostic test accuracy of the TriAGe+ score for detecting stroke in adults presenting with vertigo or dizziness: a protocol for systematic review and meta-analysis

Year: 2026

Type: review

Abstract: Introduction Vertigo and dizziness are frequently encountered neurological presentations, accounting for approximately 2%–5% of emergency department visits. These symptoms may signal stroke, especially posterior circulation stroke, which is often underdiagnosed. The TriAGe+ score is a clinical risk stratification tool that guides emergency and acute care physicians and other competent healthcare professionals in distinguishing stroke from non-stroke causes of vertigo and dizziness using easily obtainable clinical variables. However, no previous systematic review or meta-analysis has evaluated its diagnostic accuracy to date. The aim of our systematic review and meta-analysis is to assess the diagnostic accuracy of the TriAGe+ score for detecting stroke among adults presenting with vertigo or dizziness, using neuroimaging as the reference standard. Methods and analysis Our review will include cross-sectional and cohort diagnostic accuracy studies that assessed the TriAGe+ score in adults (≥18 years) against MRI-diffusion-weighted imaging, CT perfusion or non-contrast CT/blood-sensitive MRI (for haemorrhagic stroke). Searches will be conducted in databases such as MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus and Web of Science Core Collection for published studies, without any language barrier or date restrictions. Two independent reviewers will screen the studies, extract data and assess risk of bias using Quality Assessment of Diagnostic Accuracy Studies 2, and any discrepancies between them will be resolved by a third reviewer. Pooled sensitivity and specificity will be estimated using appropriate statistical models. Certainty of evidence will be evaluated by the Grading of Recommendations Assessment, Development and Evaluation approach using the GRADEpro Guideline Development tool (GDT tool. Ethics and dissemination This study involves the synthesis of data from previously published studies and does not require an ethics committee approval. No individual-level, identifiable patient data will be collected. The study findings will be disseminated through peer-reviewed publications and conference presentations at emergency medicine and neurology conferences in regional, national and international settings. PROSPERO registration number CRD420251242124.

Source: BMJ Open

DOI: 10.1136/bmjopen-2026-120945