BMC Emerg Med: Diagnostic Accuracy of Clinical Tools for Acute Stroke: Systemic Review

Re-injection therapy in acute ischemic stroke is very time-sensitive and requires early identification of eligible patients to ensure better treatment resultsAs a result, a number of clinical evaluation tools have been developed, and this review examines their diagnostic abilitiesreviewed the diagnostic performance of clinical tools currently available in identifying acute ischemic stroke, hemorrhagic stroke and stroke parodyThe literature published in 2015-2018 was systematically retrieved using PubMed, EMBASE, Scopus, and The Cochrane LibraryPre-hospital and in-hospital studies were selected, and the minimum sample size was 300 patients reported diagnostic accuracyfinally included 25 articlesThe results showed that the signs of the cerebral cortex (gaze bias, aphasia and neglect) were important indicators of large vascular blocking (LVO)Subjects with LVO were selected with sensitivity values ranging from 23% to 99%, while specific to 24% to 97%Clinical tools such as FAST-ED, NIHSS and RACE, which combine epithelial signs and motor dysfunction, show optimal diagnostic accuracyThe sensitivity of the tool to identify stroke simulations was 44% to 91%, and the specificity was 27% to 98%, with the best diagnostic effect of FABS (90% sensitivity and 91% specificity)Hypertension and young age predict edmorrhage in the brain, while atrial fibrillation and a history of diabetes are associated with ischemiaThere are differences in the method of determining the final diagnosisAbout 50% of the studies did not specify the double blindness of the indicator test evaluationin general,, in recent years, various clinical evaluation tools for acute stroke subjects have emergedThe assessment of cerebral cortex and motor function using THE assessment of the cerebral cortex, FAST-ED and NIHSS showed the optimal diagnostic accuracy of the selected LVO subjectsThe data available for clinical tools to distinguish acute ischemia and bleeding are limitedThe FABS tool does not appear to have high diagnostic accuracy in distinguishing between acute stroke and stroke simulations, and the FABS tool shows optimal diagnostic performanceFurther pre-hospital studies are needed to improve the diagnostic effectiveness of clinical evaluation, possibly using two-step clinical evaluation or simple brain imaging, such as transcranial ultrasound, to enhance the diagnostic effectiveness of clinical evaluation