Diagnostic accuracy of prehospital stroke scales in predicting LVO stratified by leukoaraiosis severitya
| Scale | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | κ |
|---|---|---|---|---|---|
| Total cohort (n = 274) | |||||
| 3I/SS ≥4 | 22 (11–36) | 90 (86–94) | 31 (19–47) | 85 (83–87) | 0.14 (0–0.28) |
| VAN ≥2 | 70 (54–82) | 63 (57–69) | 28 (23–33) | 91 (87–94) | 0.20 (0.10–0.30) |
| CPSSS ≥2 | 41 (27–57) | 79 (74–84) | 29 (19–47) | 87 (84–90) | 0.18 (0.05–0.31) |
| RACE ≥5 | 50 (35–65) | 85 (80–89) | 40 (31–51) | 89 (86–92) | 0.32 (0.18–0.46) |
| FAST-ED ≥4 | 57 (41–71) | 79 (73–84) | 35 (27–43) | 90 (83–87) | 0.28 (0.15–0.41) |
| Absent-to-mild leukoaraiosis (Fazekas scale score, 0–2; n = 129) | |||||
| 3I/SS ≥4 | 50 (21–79) | 88 (80–94) | 33 (18–52) | 94 (89–96) | 0.09 (0–0.27) |
| VAN ≥2 | 73 (54–88) | 68 (58–77) | 41 (32–50) | 89 (82–94) | 0.32 (0.16–0.48) |
| CPSSS ≥2 | 37 (20–56) | 87 (79–93) | 46 (30–63) | 82 (77–86) | 0.25 (0.06–0.45) |
| RACE ≥5 | 53 (34–72) | 91 (83–96) | 64 (46–78) | 87 (81–90) | 0.47 (0.29–0.65) |
| FAST-ED ≥4 | 57 (37–75) | 84 (75–90) | 52 (38–65) | 86 (81–91) | 0.39 (0.09–0.57) |
| Moderate-to-severe leukoaraiosis (Fazekas scale score, 3–6; n = 145) | |||||
| 3I/SS ≥4 | 25 (7–52) | 92 (86–96) | 29 (12–53) | 91 (88–93) | 0.18 (0–0.41) |
| VAN ≥2 | 63 (35–85) | 60 (51–68) | 16 (11–23) | 93 (87–96) | 0.10 (0–0.22) |
| CPSSS ≥2 | 50 (25–75) | 74 (65–81) | 19 (12–29) | 92 (88–95) | 0.14 (0–0.29) |
| RACE ≥5 | 44 (20–70) | 81 (73–87) | 22 (13–35) | 92 (88–94) | 0.17 (0–0.35) |
| FAST-ED ≥4 | 56 (30–80) | 74 (66–82) | 21 (14–32) | 93 (89–96) | 0.11 (0–0.27) |
Note:—NPV indicates negative predictive value; PPV, positive predictive value.
↵a Data in parentheses are 95% CI.