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A nomogram-based clinical tool for acute ischemic stroke screening in prehospital setting
Alireza Baratloo1,2, Mahtab Ramezani3,4, Hosein Rafiemanesh5,6
1Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran.
Current Journal of Neurology
|November 27, 2023
Summary
A new clinical tool aids in the rapid and accurate prehospital diagnosis of acute ischemic stroke (AIS). This tool demonstrates comparable sensitivity and specificity to existing methods for faster emergency care.
Area of Science:
- Neurology
- Emergency Medicine
- Diagnostic Tools
Background:
- Accurate prehospital diagnosis of acute ischemic stroke (AIS) is crucial for timely treatment.
- Existing diagnostic tools vary in sensitivity and specificity, necessitating improved options.
- Developing a new, highly accurate prehospital tool can significantly impact patient outcomes.
Purpose of the Study:
- To develop and validate a novel clinical tool for the prehospital diagnosis of AIS.
- To assess the diagnostic accuracy, sensitivity, and specificity of the new tool.
- To compare the new tool's performance against established prehospital stroke screening scales.
Main Methods:
- A cross-sectional diagnostic accuracy study involving 806 patients.
- Evaluation using 9 established prehospital stroke scales and 19 recorded items.
- Development of a new tool via multivariable logistic regression (backward method).
- Assessment of diagnostic power using Area Under the Receiver Operating Characteristic Curve (AUC-ROC).
Main Results:
- The new tool, derived from 8 key items, achieved an AUC-ROC of 0.893 (95% CI: 0.869-0.917).
- Optimal cut-off score (≥3) yielded a sensitivity of 84.42% and specificity of 79.72%.
- The tool demonstrated strong discriminatory power for AIS diagnosis in the prehospital setting.
Conclusions:
- A new nomogram-based clinical tool for prehospital AIS diagnosis has been developed.
- The tool exhibits acceptable sensitivity and specificity, comparable to existing methods.
- This novel tool offers a promising advancement for rapid and accurate prehospital stroke identification.
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