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Only sex (male) and focal motor deficit were independent predictors of positive CTB at univariate analysis. The ECHS did not perform as anticipated in our population, with a ROC area under the curve of 0.498. An ECHS score of 0, which has been proposed as the threshold to not require imaging, had sensitivity of only 83.3% in our population. Further research and validation is required in order to safely implement the ECHS clinical score in the Australian ED setting. Further research and validation is required in order to safely imple