ABCD2 Score
Estimates short-term stroke risk after TIA
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- Emergency department, Inpatient
When it activates
Scribeable activates a calculator from the encounter. The ABCD2 Score can activate when the transcript or pasted chart context documents any of these:
- TIA evaluation
- Transient neurological symptoms
- Post-TIA disposition
- Stroke risk stratification after TIA
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: G45.
Note-type scope: it activates on notes whose subject resolves to neurology, emergency medicine, critical care. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
5 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Age >=60 | age | ||
| BP >=140/90 | vital | mmHg | |
| Unilateral weakness vs speech only | symptom |
| ABCD2 clinical features: unilateral weakness = 2 points, speech disturbance without weakness = 1, neither = 0. Asked as: “During the TIA, did the patient have unilateral weakness, speech disturbance without weakness, or neither?” |
| Symptom duration (minutes) | symptom | minutes | Duration of the TIA symptoms IN MINUTES (≥60 = 2 points, 10–59 = 1, <10 = 0). Asked as: “How long did the TIA symptoms last, in minutes?” |
| Diabetes | history | Type 1 or type 2 diabetes mellitus (ABCD2: 1 point). Asked as: “Does the patient have diabetes mellitus?” |
Scoring
A: Age>=60 (+1). B: BP>=140/90 (+1). C: Weakness (+2) or speech only (+1). D: Duration >=60min (+2) or 10-59min (+1). D: Diabetes (+1).
Age≥60 Age >=60 + BP≥140/90 BP >=140/90 + Clinical features Unilateral weakness vs speech only (weakness=2, speech only=1) + Duration Symptom duration (minutes) (≥60min=2, 10-59min=1) + Diabetes Diabetes
Interpretation
0-2: Low risk (1-1.4%). 4-5: Moderate (4.1%). 6-7: High (8.1%). Higher scores warrant urgent workup/admission.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Johnston SC et al. Validation and refinement of scores to predict very early stroke risk after TIAJohnston et al. (ABCD2) 2007 · 2007 · Level I · link last verified 2026-03-23
How Scribeable handles it in the note
When an encounter activates the ABCD2 Score at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a ABCD2 Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a mandatory rule-out score: a missed result carries acute harm, so the activation filter never approves it on uncertainty.
See it activate on your own encounter
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