SynthesisNeurology2014
Prehospital stroke scales in urban environments: a systematic review.
Synthesis in Neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
68 citing papers in PubMed, 5 syntheses or guidelines pooled it, 157 citations in OpenAlex.
- A topical review of the feasibility and reliability of ambulance-based telestroke.Frontiers in stroke · 2024Pooled it
- A Systematic Review and Meta-Analysis Comparing FAST and BEFAST in Acute Stroke Patients.Frontiers in neurology · 2021Pooled it
- A systematic review and meta-analysis to evaluate the diagnostic accuracy of recognition of stroke in the emergency department (ROSIER) scale.BMC neurology · 2020Pooled it
- Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack.The Cochrane database of systematic reviews · 2019Pooled it
- Prehospital Prediction of Large Vessel Occlusion in Suspected Stroke Patients.Current atherosclerosis reports · 2018Pooled it
- Presenting symptoms and diagnostic accuracy of prehospital stroke scales for patients with suspected mild minor stroke.European stroke journal · 2026Trial
- Neurologic Improvement in Acute Cerebral Ischemia: Frequency, Magnitude, Predictors, and Clinical Outcomes.Neurology · 2023Trial
- Predicting stroke severity with a 3-min recording from the Muse portable EEG system for rapid diagnosis of stroke.Scientific reports · 2020Trial
- Presenting symptoms and diagnostic accuracy of prehospital stroke scales for patients with suspected mild minor stroke.European stroke journal · 2025Article
- Prehospital stroke detection scales: A head-to-head comparison of 7 scales in patients with suspected stroke.International journal of stroke : official journal of the International Stroke Society · 2025Review
- Prehospital technologies for early stroke detection - A review.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Review
- Standardizing Domains and Metrics of Stroke Recovery: A Systematic Review.Brain sciences · 2024Review
- A Two-Step Approach Using the National Health Institutes of Health Stroke Scale Assessed by Paramedics to Enhance Prehospital Stroke Detection: A Case Report and Concept Proposal.Journal of clinical medicine · 2024Article
- A Review of emergency medical services for stroke.African health sciences · 2024Review
- YouTube as a source of recognizing acute stroke; progress in 2 years.BMC public health · 2024Article
- Article
- Experiences from a cluster-randomized trial (ParaNASPP) exploring triage and diagnostic accuracy in paramedic-suspected stroke: a qualitative interview study.European journal of neurology · 2024Article
- Implementation of a Thrombectomy Stroke Center Triage Program in New York City Emergency Medical Services.Stroke (Hoboken, N.J.) · 2024Article
- Derivation and Validation of an Algorithm to Detect Stroke Using Arm Accelerometry Data.Journal of the American Heart Association · 2023Article
- A Machine Learning Approach to Support Urgent Stroke Triage Using Administrative Data and Social Determinants of Health at Hospital Presentation: Retrospective Study.Journal of medical Internet research · 2023Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on byAuthor response.2015
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo identify and compare the operating characteristics of existing prehospital stroke scales to predict true strokes in the hospital.
methodsWe searched MEDLINE, EMBASE, and CINAHL databases for articles that evaluated the performance of prehospital stroke scales. Quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We abstracted the operating characteristics of published prehospital stroke scales and compared them statistically and graphically.
resultsWe retrieved 254 articles from MEDLINE, 66 articles from EMBASE, and 32 articles from CINAHL Plus database. Of these, 8 studies met all our inclusion criteria, and they studied Cincinnati Pre-Hospital Stroke Scale (CPSS), Los Angeles Pre-Hospital Stroke Screen (LAPSS), Melbourne Ambulance Stroke Screen (MASS), Medic Prehospital Assessment for Code Stroke (Med PACS), Ontario Prehospital Stroke Screening Tool (OPSS), Recognition of Stroke in the Emergency Room (ROSIER), and Face Arm Speech Test (FAST). Although the point estimates for LAPSS accuracy were better than CPSS, they had overlapping confidence intervals on the symmetric summary receiver operating characteristic curve. OPSS performed similar to LAPSS whereas MASS, Med PACS, ROSIER, and FAST had less favorable overall operating characteristics.
conclusionsPrehospital stroke scales varied in their accuracy and missed up to 30% of acute strokes in the field. Inconsistencies in performance may be due to sample size disparity, variability in stroke scale training, and divergent provider educational standards. Although LAPSS performed more consistently, visual comparison of graphical analysis revealed that LAPSS and CPSS had similar diagnostic capabilities.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.