Validation of Recognition of Stroke in the Emergency Room scale in Turkish population and comparison of its efficiency with Face-Arm-Speech Test

Abstract

BACKGROUND: Various risk scores were developed to recognize acute stroke easily and to start treatment right away in the emergency departments. Although the Recognition of Stroke in the Emergency Room (ROSIER) score used for this purpose is indicated better than the other scoring systems, it is expressed that it will be able to have social differentiations. In this study, we targeted to research validation of the ROSIER scale and to compare its efficiency with Face-Arm-Speech Test (FAST), another stroke diagnosis method, for the patients who applied to the emergency department with the stroke or transient ischemic attack symptoms. MATERIAL AND METHODS: The patients who reported to the emergency department with the suggestive symptoms or findings of stroke and were above 18 years of age were included in the study. The study forms were filled out by the emergency medicine specialist or the senior emergency medical assistant after the patients were evaluated, and then they were consulted by the neurology specialist. The final diagnosis, which was established after the clinical evaluation and necessary imaging done by the neurology specialists, was accepted as a standard reference. RESULTS: A total of 335 patients, including 168 (50.1%) females, were included in the study. The sensitivity was 68.5%, specificity was 79.0%, Positive Predictive Value (PPV) was 78.7%, NPV (Negative Predictive Value) was 68.9%, and test validity was 73.4% for the ROSIER scale. For the FAST scale the sensitivity was 63.5%, specificity was 88.5%, PPV was 86.3%, NPV was 68.1%, and test validity was 75.2%. CONCLUSION: In the present study, it was seen that the ROSIER scale could be used in separating the patients with CVO (cerebrovascular accident) from the patients who applied with the similar clinical findings. However, FAST was superior because its specificity and PPV were higher and its practicability was easier than the ROSIER.