Compared with the general population, patients with NTG had greatest HRQoL impairment at baseline on the Goiter Symptoms and Anxiety scales, which also demonstrated the largest post-treatment improvements. However, both disease-specific and generic HRQoL deficits persisted six months after treatment. In order to improve individualized care, future studies should focus on identifying risk factors for persistent HRQoL deficits and compare HRQoL effects of the various goiter treatment modalities in relation to thyroid phenotype.

The SF-36 responds to treatment impact, distinguishing drug therapies that, on average, produce meaningful functional health benefits. Overall, just over half of clinically efficacious trials report meaningful functional health improvements, and results vary widely by medical condition.

Background and Purpose-The Cincinnati Prehospital Stroke Scale (CPSS) is recommended for emergency medical services use in identifying patients with stroke. Data evaluating its performance in the field are limited. We assessed the impact of training and use of the CPSS on the accuracy of paramedics' stroke patient identification and on-scene time. Methods-A 1-hour interactive educational presentation on the use of the CPSS was conducted for paramedics transporting patients to an academic medical center. Patients with stroke/transient ischemic attack (TIA) were identified retrospectively from paramedic records and were compared with the hospital's prospective stroke registry for the year before and after the training. Results-There were 154 patients with suspected stroke/transient ischemic attack identified (56% women, 53% white, 44% black, mean age 67Ϯ16 years). There was no difference in paramedics' use of the CPSS (37.5% versus 23.8%, Pϭ0.123) or accuracy of stroke/TIA patient identification (40.5% versus 38.9%, Pϭ0.859) before and after training. Of responsive patients identified by paramedics as having a stroke/TIA, 57% had an abnormality in at least one CPSS item with no effect on on-scene time (17Ϯ6 minutes with a normal versus 18Ϯ6 minutes with an abnormal CPSS, Pϭ0.492). Those with a final diagnosis of stroke/TIA (nϭ61, 40%) more frequently had at least one abnormal CPSS item (70% versus 30%, Pϭ0.008, sensitivity 0.71, specificity 0.52) with 49% of patients with an abnormality having a discharge diagnosis of stroke/TIA. Conclusions-Paramedic

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