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Accuracy of prehospital ambulance stroke test in terms of diagnosis of patients with acute ischemic stroke: A multi-center study

  • Karimi, Somayeh1, 2
  • Heydari, Farhad3
  • Mirbaha, Sahar4
  • Elfil, Mohamed5
  • Baratloo, Alireza1, 2
  • 1 Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • 2 Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • 3 Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  • 4 Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • 5 Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
Published Article
Current Journal of Neurology
Tehran University of Medical Sciences
Publication Date
Oct 06, 2020
DOI: 10.18502/cjn.v19i4.5547
PMCID: PMC8236426
PubMed Central
  • Short Communication


Background: Andsberg et al. have recently introduced a novel scoring system entitled “PreHospital Ambulance Stroke Test (PreHAST)”, which helps to early identification of patients with acute ischemic stroke (AIS) even in prehospital setting. Its validity has not been assessed in a study yet, and the purpose of this study was to assess this scoring system on a larger scale to provide further evidence in this regard. Methods: This was a cross-sectional multi-center accuracy study, in which, sampling was performed prospectively. All patients over 18 years of age admitted to the emergency department (ED) and suspected as AIS cases were included. All required data were recorded in a form consisting of 3 parts: baseline characteristics, neurological examination findings required for calculating PreHAST score, and the ultimate diagnosis made from interpretation of their brain magnetic resonance imaging (MRI). Results: Data from 805 patients (57.5% men) with the mean age of 67.1 ± 13.6 years were analyzed. Of all the patients presenting with suspected AIS, 562 (69.8%) had AIS based on their MRI findings. At the suggested cut-off point (score ≥ 1), PreHAST had a specificity of 46.5% [95% confidence interval (CI): 40.1%-53.0%) and a sensitivity of 93.2% (95% CI: 90.8%-95.2%). Conclusion: According to the findings of our study, at the suggested cut-off point (score ≥ 1), PreHAST had 93.2% sensitivity and 46.5% specificity in detection of patients with AIS, which were somewhat different from those reported in the original study, where 100% sensitivity and 40% specificity were reported for this scoring system.

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