Transcranial Doppler: Evaluation of Intracranial Occlusive Cerebrovascular Disease: A Methodological Perspective

Noninvasive tests used to evaluate the stroke-prone patient need to be studied by rigorous methods. Clinicians need reliable data to avoid confusion over the wide reported ranges of diagnostic test performance, ranging from poor to perfect. Published studies of large groups of patients who are representative of the patients in whom the tests will ultimately be used are needed in order for physicians to adopt rigorous diagnostic algorithms effectively. Such algorithms reduce the undesirable clinical consequences of false-positive and false-negative test errors, and the expense of identifying diseases that cause stroke, such as intracranial atherosclerotic stenosis. This review focuses on the methodology used to evaluate the performance of transcranial Doppler, an ultrasound test used to identify intracranial atherosclerotic stenosis.