From: Diagnostic accuracy of clinical tools for assessment of acute stroke: a systematic review
Clinical assessment | Se | Sp | PPV | NPV | AUC |
---|---|---|---|---|---|
ACT-FAST [18] | 0.85 | 0.93 | 0.53 | 0.99 | 0.90 |
aNIHSS ≥1 [27] | 0.95 | 0.31 | 0.40 | 0.92 | – |
a-NIHSS item profile A ≥ 3 [37] | 0.64 | 0.69 | 0.76 | 0.55 | 0.66 |
a-NIHSS item profile B ≥ 2 [37] | 0.75 | 0.64 | 0.76 | 0.63 | 0.71 |
a-NIHSS item profile C ≥ 2 [37] | 0.51 | 0.73 | 0.75 | 0.50 | 0.60 |
a-NIHSS item profile D ≥ 2 [37] | 0.76 | 0.61 | 0.75 | 0.62 | 0.70 |
a-NIHSS item profile E ≥ 2 [37] | 0.71 | 0.65 | 0.76 | 0.60 | 0.68 |
Aphasia; Neglect/gaze deviation [19] | 0.91 | 0.70 | 0.60 | 0.94 | 0.77 |
Arm weakness [14] | 0.96 | 0.41 | 0.18 | 0.99 | 0.68 |
Arm weakness; Leg weakness; Dysarthria [20] | 0.92 | 0.44 | 0.28 | 0.96 | – |
Bernese score 1 ≥ 5 [37] | 0.73 | 0.79 | 0.85 | 0.66 | 0.76 |
Bernese score 2 ≥ 2 [37] | 0.71 | 0.80 | 0.84 | 0.64 | 0.74 |
Bernese score 3 ≥ 2 [37] | 0.67 | 0.86 | 0.88 | 0.63 | 0.75 |
Bernese score 4 ≥ 1 [37] | 0.67 | 0.83 | 0.86 | 0.63 | 0.74 |
Bernese score 5 ≥ 3 [37] | 0.77 | 0.83 | 0.87 | 0.70 | 0.79 |
CPSS ≥1 [27] | 0.96 | 0.24 | 0.38 | 0.93 | – |
0.56–0.92 | 0.81–0.85 | 0.40–0.65 | 0.78–0.99 | 0.75–0.78 | |
CPSS1 ≥ 2 [37] | 0.59 | 0.77 | 0.80 | 0.55 | 0.66 |
CPSS2 ≥ 2 [37] | 0.73 | 0.71 | 0.79 | 0.63 | 0.72 |
0.60–0.86 | 0.80–0.87 | 0.88 | 0.59 | 0.71 | |
0.59–0.83 | 0.40–0.89 | 0.66–0.77 | 0.77–0.83 | 0.72–0.80 | |
CPSSS ≥3 [38] | 0.51 | 0.93 | – | – | – |
CPSSS =4 [38] | 0.25 | 0.96 | – | – | – |
C-STAT [13] | 0.54 | 0.91 | 0.45 | 0.93 | 0.79 |
0.47–0.85 | 0.68–0.85 | 0.35–0.40 | 0.88–0.98 | 0.65–0.85 | |
DIRECT criteria [16] | 0.74 | 0.92 | 0.43 | 0.98 | 0.91 |
EMSA ≥3 [8] | 0.75 | 0.50 | – | – | 0.69 |
Expressive aphasia [14] | 0.39 | 0.64 | 0.13 | 0.88 | 0.52 |
Facial weakness [14] | 0.93 | 0.50 | 0.20 | 0.98 | 0.72 |
FAST = 3 [17] | 0.84 | 0.44 | 0.32 | 0.90 | 0.53 |
FAST-ED [13] | 0.62 | 0.84 | 0.40 | 0.94 | 0.84 |
FAST-ED ≥3 [26] | 0.71 | 0.78 | 0.62 | 0.84 | 0.76 |
0.42–0.96 | 0.82–0.90 | 0.24–0.80 | 0.82–1.00 | 0.64–0.91 | |
FPSS [13] | 0.54 | 0.91 | 0.47 | 0.93 | 0.85 |
Gaze deviation [14] | 0.84 | 0.73 | 0.30 | 0.97 | 0.79 |
0.75–0.89 | 0.39–0.83 | 0.31–0.39 | 0.92–0.96 | 0.51–0.85 | |
G-FAST =4 [13] | 0.36 | 0.97 | 0.59 | 0.91 | |
0.57–0.94 | 0.74–0.85 | 0.28–0.66 | 0.78–0.99 | 0.70–0.89 | |
mNIHSS ≥5 [37] | 0.78 | 0.76 | 0.85 | 0.69 | 0.78 |
mNIHSS ≥7 [27] | 0.77 | 0.77 | 0.62 | 0.87 | – |
MPSS ≥3 [27] | 0.84 | 0.65 | 0.54 | 0.89 | – |
Neglect [14] | 0.88 | 0.69 | 0.28 | 0.98 | 0.79 |
Neglect/gaze deviation [14] | 0.95 | 0.64 | 0.27 | 0.99 | 0.79 |
0.93–0.99 | 0.24–0.46 | 0.15–0.46 | 0.93–0.99 | 0.62 | |
NIHSS ≥5 [27] | 0.90 | 0.54 | 0.49 | 0.92 | – |
0.66–0.99 | 0.39–0.70 | 0.18–0.55 | 0.85–1.00 | 0.68–0.72 | |
0.81 | 0.72–0.77 | 0.59–0.84 | 0.72–0.89 | 0.79 | |
0.72–0.98 | 0.48–0.81 | 0.21–0.71 | 0.82–0.99 | 0.71 | |
0.53–0.81 | 0.72–0.85 | 0.59–0.75 | 0.81–0.89 | – | |
0.64–0.98 | 0.56–0.88 | 0.23–0.78 | 0.80–0.99 | 0.75–0.84 | |
NIHSS ≥14 [27] | 0.61 | 0.88 | 0.72 | 0.82 | – |
NIHSS-8 [13] | 0.63 | 0.89 | 0.44 | 0.94 | 0.84 |
NIHSS-8 ≥ 8 [7] | 0.81 | 0.75 | 0.52 | 0.92 | 0.82 |
NIHSS subitem – LoC (1a) [14] | 0.23 | 0.81 | 0.14 | 0.88 | 0.52 |
NIHSS subitem – LoC (1b) [14] | 0.60 | 0.56 | 0.16 | 0.91 | 0.58 |
NIHSS subitem – LoC (1c) [14] | 0.49 | 0.68 | 0.17 | 0.91 | 0.59 |
NIHSS; Absence of prestroke handicap (mRS ≤ 2); Hemineglect; AF; Female sex; Total score cut-off ≥16 [39] | 0.84 | 0.68–0.71 | 0.41–0.54 | 0.92–0.94 | 0.84 |
NIHSS symptom profile A or B [17] | 0.76 | 0.65 | 0.40 | 0.90 | 0.68 |
OoH-NIHSS ≥1 [27] | 0.96 | 0.24 | 0.38 | 0.93 | – |
PASS [13] | 0.69 | 0.85 | 0.40 | 0.95 | 0.81 |
0.64–0.96 | 0.59–0.84 | 0.33–0.74 | 0.81–1.00 | 0.63–0.89 | |
Pomona ≥1 [14] | 0.98 | 0.50 | 0.21 | 0.99 | 0.74 |
Pomona ≥2 [14] | 0.86 | 0.71 | 0.71 | 0.97 | 0.79 |
RACE ≥3 [37] | 0.74 | 0.80 | 0.85 | 0.67 | 0.77 |
0.46–0.92 | 0.68–0.91 | 0.27–0.81 | 0.78–0.99 | 0.67–0.90 | |
RACE V1 ≥ 4 [28] | 0.85 | 0.56 | – | – | 0.81 |
RACE V2 ≥ 4 [28] | 0.85 | 0.62 | – | – | 0.79 |
RACE V3 ≥ 3 [28] | 0.89 | 0.48 | – | – | 0.78 |
RACE V4 ≥ 4 [28] | 0.87 | 0.56 | – | – | 0.80 |
RACE V5 ≥ 4 [28] | 0.83 | 0.57 | – | – | 0.79 |
RACE V6 ≥ 4 [28] | 0.83 | 0.63 | – | – | 0.77 |
RACE V7 ≥ 3 [28] | 0.87 | 0.51 | – | – | 0.76 |
Reduced level of consciousness with inability to answer questions; Leg weakness; Dysarthria; Gaze deviation [20] | 0.96 | 0.39 | 0.27 | 0.98 | – |
Reduced level of consciousness with inability to answer questions; Facial weakness; Arm weakness; Sensation loss; Aphasia [20] | 0.99 | 0.28 | 0.99 | 0.25 | – |
Reduced level of consciousness with inability to answer questions; Leg weakness; Neglect; Gaze deviation [20] | 0.85 | 0.45 | 0.26 | 0.93 | – |
rNIHSS (profile A, B, C, D or E vs. profile F) [27] | 0.83 | 0.61 | 0.51 | 0.88 | – |
ROSIER ≥4 [27] | 0.79 | 0.76 | 0.61 | 0.88 | – |
sCPSSS (severe arm weakness, conjugate gaze deviation) ≥1 [38] | 0.83 | 0.83 | |||
sCPSSS ≥2 [38] | 0.59 | 0.90 | |||
sCPSSS =3 [38] | 0.50 | 0.94 | |||
sNIHSS-1 ≥ 1 [37] | 0.63 | 0.80 | 0.83 | 0.59 | 0.70 |
sNIHSS-1 ≥ 2 [27] | 0.66 | 0.81 | 0.63 | 0.83 | |
sNIHSS-5 ≥ 2 [37] | 0.76 | 0.77 | 0.84 | 0.68 | 0.76 |
sNIHSS-5 ≥ 3 [24] | 0.69 | 0.81 | 0.70 | 0.80 | 0.80 |
sNIHSS-5 ≥ 4 [27] | 0.72 | 0.80 | 0.63 | 0.85 | – |
sNIHSS-8 ≥ 4 [37] | 0.78 | 0.76 | 0.84 | 0.69 | 0.77 |
0.64–0.77 | 0.78–0.88 | 0.63–0.78 | 0.79–0.88 | 0.82 | |
sNIHSS-EMS ≥6 [24] | 0.70 | 0.81 | 0.70 | 0.81 | 0.81 |
VAN [14] | 0.95 | 0.56 | 0.23 | 0.99 | 0.77 |
Visual field defect [14] | 0.88 | 0.75 | 0.33 | 0.98 | 0.82 |
0.42–0.50 | 0.92–0.93 | 0.45–0.77 | 0.77–0.92 | 0.71–0.78 | |
3I-SS ≥1 [37] | 0.73 | 0.78 | 0.83 | 0.65 | 0.75 |
3I-SS ≥2 [17] | 0.65 | 0.72 | 0.42 | 0.87 | 0.71 |
0.19–0.40 | 0.94–0.95 | 0.74–0.85 | 0.71–0.74 | 0.65–0.80 |