Skip to main content

Table 2 Diagnostic accuracy values of clinical tools for selecting subjects with large vessel occlusion

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

CPSS ≥2 [14, 26]

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

CPSSS ≥1 [37, 38]

0.60–0.86

0.80–0.87

0.88

0.59

0.71

CPSSS ≥2 [9, 10, 24, 27, 38]

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

C-STAT ≥2 [8, 17, 18]

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

FAST-ED ≥4 [8, 18, 24, 26]

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

G-FAST ≥3 [13, 17]

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

 

LAMS ≥4 [9, 14, 18]

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

NIHSS ≥4 [14, 27]

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

NIHSS ≥6 [8, 14, 26, 27]

0.66–0.99

0.39–0.70

0.18–0.55

0.85–1.00

0.68–0.72

NIHSS ≥7 [27, 37]

0.81

0.72–0.77

0.59–0.84

0.72–0.89

0.79

NIHSS ≥8 [14, 24]

0.72–0.98

0.48–0.81

0.21–0.71

0.82–0.99

0.71

NIHSS ≥9 [8, 24, 27]

0.53–0.81

0.72–0.85

0.59–0.75

0.81–0.89

NIHSS ≥10 [14, 24, 26, 27, 39]

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

PASS ≥2 [9, 14, 17, 18, 24]

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

RACE ≥5 [8, 9, 16,17,18, 24, 26,27,28]

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

sNIHSS-8 ≥ 6 [24, 27]

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

3I-SS [9, 13]

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

3I-SS ≥4 [8, 24, 27]

0.19–0.40

0.94–0.95

0.74–0.85

0.71–0.74

0.65–0.80

  1. Abbreviations: AUC area under the curve, NPV negative predictive value, PPV positive predictive value, Se sensitivity, Sp specificity