Trial reportStroke2022
Streamlining Acute Stroke Care by Introducing National Institutes of Health Stroke Scale in the Emergency Medical Services: A Prospective Cohort Study.
Trial report in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03158259 (Advanced Diagnostics of Acute Stroke), which is not on this map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Advanced Diagnostics of Acute Stroke (Biomarkers, Blood Analysis, Stroke Scales and Cerebral CT Examinations) and Initiation of rtPa Treatment in an Air Ambulance Model
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations between basic physiological observations recorded pre-thrombectomy and functional outcome: a systematic review and meta-analysis.Frontiers in stroke · 2023Pooled it
- Diagnostic performance of prehospital large-vessel occlusion detection scales in patients with suspected acute stroke: a retrospective validation study. The Akershus Study of Ischemic Stroke and Thrombolysis.European stroke journal · 2026Observational
- Clinical variable-based decision-support model for rapid differentiation of hemorrhagic and ischemic stroke at emergency department presentation in South Korea.Acute and critical care · 2026Article
- Low hemoglobin-albumin-lymphocyte-platelet score as a risk marker for stroke-associated pneumonia in acute ischemic stroke: a retrospective cohort study.Frontiers in neurology · 2026Article
- Prehospital stroke care in low- and middle-income countries: A World Stroke Organization (WSO) scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025Review
- The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients With Stroke in Korea: An Interrupted Time Series Analysis.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2025Article
- Factors affecting emergency medical dispatchers decision making in stroke calls - a qualitative study.BMC emergency medicine · 2024Article
- 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
- Improved Precision and Safety of Supra-Tentorial Intracranial Hematoma Puncture Using C-Arm CT Four-Dimensional Navigation.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- 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
- Prehospital identification of intracerebral haemorrhage: a scoping review of early clinical features and portable devices.BMJ open · 2024Article
- The non-paretic-hand-to-opposite-ear test: A simple test to detect aphasia and neglect and an indicator of large anterior vessel occlusion in patients with suspected acute stroke.Brain and behavior · 2024Observational
- Knowledge on Stroke Recognition and Management among Emergency Department Healthcare Professionals in the Republic of Cyprus.Healthcare (Basel, Switzerland) · 2023Article
- Uncooperative patients suspected of acute stroke ineligible for prehospital stroke screening test by emergency medical service providers: final hospital diagnoses and characteristics.Clinical and experimental emergency medicine · 2023Article
- Article
- Gamification of the National Institutes of Health Stroke Scale (NIHSS) for simulation training-a feasibility study.Advances in simulation (London, England) · 2023Article
- Diagnostic performance of Glial Fibrillary Acidic Protein and Prehospital Stroke Scale for identification of stroke and stroke subtypes in an unselected patient cohort with symptom onset < 4.5 h.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Inter-Rater Agreement on Cincinnati Prehospital Stroke Scale (CPSS) and Prehospital Acute Stroke Severity Scale (PASS) Between EMS Providers, Neurology Residents and Neurology Consultants.Clinical epidemiology · 2023Article
- OEDL: an optimized ensemble deep learning method for the prediction of acute ischemic stroke prognoses using union features.Frontiers in neurology · 2023Article
- Validation of a cloud-based tele-stroke system reliability in determining national institutes of health stroke scale scores for acute ischemic stroke screening in the emergency department.Frontiers in neurology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNational Institutes of Health Stroke Scale (NIHSS) is the most validated clinical scale for stroke recognition, severity grading, and symptom monitoring in acute care and hospital settings. Numerous modified prehospital stroke scales exist, but these scales contain less clinical information and lack compatibility with in-hospital stroke scales. In this real-life study, we aimed to investigate if NIHSS conducted by paramedics in the field is a feasible and accurate prehospital diagnostic tool.
methodsThis prospective cohort study is part of Treat-NASPP (Treat-Norwegian Acute Stroke Prehospital Project) conducted at a single medical center in Østfold, Norway. Sixty-three paramedics were trained and certified in NIHSS, and the prehospital NIHSS scores were compared with the scores obtained by in-hospital stroke physicians. Interrater agreement was assessed using a Bland-Altman plot with 95% limits of agreement. In secondary analysis, Cohen κ was used for the clinical categories NIHSS score of 0 to 5 and ≥6. As a safety measure, prehospital time was compared between paramedics conducting NIHSS and conventional paramedics.
resultsWe included 274 patients. The mean difference in NIHSS scores between the paramedics and the stroke physicians was 0.92 with limits of agreement from -5.74 to 7.59. Interrater agreement for the 2 clinical categories was moderate with a κ of 0.58. The prehospital NIHSS scoring was performed mean (SD) 42 (14) minutes earlier than the in-hospital scoring. Prehospital time was not significantly increased in the NIHSS-trained paramedic group compared with conventional paramedics (median [interquartile range] on-scene-time 18 [13-25] minutes versus 16 [11-23] minutes,
conclusionsParamedics can use NIHSS as an accurate and time efficient prehospital stroke severity quantification tool. Introducing NIHSS in the emergency medical services will enable prehospital evaluation of stroke progression and provide a common language for stroke assessment between paramedics and stroke physicians. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03158259.
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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.