Practical guidance on use of TEARS-Q to diagnose post-stroke emotionalism.
Niall M Broomfield, Robert West, Mark Barber and 3 others
PMID 34134538WHAT IT FOUND
A self-report questionnaire for post-stroke emotionalism uses three score ranges to guide care.
Scores of 0-1 rule out the condition, 6-16 confirm it, and 2-5 require a full interview. This triage reduced the need for detailed assessment to just 9% of the sample.
Key findings
01Participants with TEARS-Q scores of 0 or 1 had a very low likelihood of post-stroke emotionalism (6% diagnosed), allowing them to be screened out without further assessment.
02Participants with TEARS-Q scores of 6 or higher had a very high probability of post-stroke emotionalism (88% diagnosed), allowing them to be screened in for intervention consideration.
03Participants with intermediate scores (2-5) showed diagnostic uncertainty (52% diagnosed), indicating that a full standardized diagnostic interview is required for this group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Participants with aphasia were excluded, so the tool's performance is unknown for this common post-stroke population. The same nurses administered both the questionnaire and the diagnostic interview on the same day, which may have influenced results due to lack of blinding. The sample was relatively young, had mild strokes, and was drawn primarily from West of Scotland, limiting generalizability to more severe or diverse populations. The reference standard interview was developed by the authors and not based on a previously published standardized schedule. Nearly 6% of participants who had emotionalism on the interview were missed by the TEARS-Q.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not use TEARS-Q for patients with aphasia, as they were excluded from the study. Additionally, a score of 2-5 does not confirm or rule out emotionalism; these patients require a full diagnostic interview before any treatment decisions are made.