What does this research mean for the field?

Existing prehospital clinical stroke scales are not sufficiently accurate to reliably detect large-vessel occlusion in real-world settings, and their performance varies significantly by stroke laterality, patient age, and stroke severity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Assess the diagnostic performance of prehospital scales for detecting large-vessel occlusion in stroke patients.

June 20, 2026European Stroke Journal

Diagnostic performance of prehospital large-vessel occlusion detection scales in patients with suspected acute stroke: a retrospective validation study. The Akershus Study of Ischemic Stroke and Thrombolysis

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Authors

SJSilje Holt JahrUniversity of Oslo MSMaiken Nordahl SelsethAkershus University Hospital KLKristin Tveitan LarsenOslo University Hospital

Discussion

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Implication

Retrospective validation study evaluates prehospital scale accuracy for detecting large-vessel occlusion in stroke patients, suggesting limitations in clinical use.

Key Points

Assess the diagnostic performance of prehospital scales for detecting large-vessel occlusion in stroke patients.
Retrospective analysis of 1150 patients under stroke code protocol (2015-2017).
Evaluation of 55 scale-threshold combinations for computed tomography angiography-confirmed large-vessel occlusion detection.
Quantified accuracy using area under the receiver operating characteristic curve, sensitivity, specificity, and predictive values.
Large-vessel occlusion prevalence was 13.5%.
AUC ranged from 0.586 to 0.855; no scale surpassed the NIHSS after correction (AUC 0.851).
Accuracy varied with stroke laterality and age, with left-hemispheric strokes and older patients showing better AUC.

Cite This Study

Jahr et al. (2026) studied this question.

synapsesocial.com/papers/6a363274db0793dc1a539094 https://doi.org/10.1093/esj/aakag067

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June 20, 2026European Stroke Journal

Diagnostic performance of prehospital large-vessel occlusion detection scales in patients with suspected acute stroke: a retrospective validation study. The Akershus Study of Ischemic Stroke and Thrombolysis

View Full Paper

Ask AI

Bookmark

Authors

SJSilje Holt JahrUniversity of Oslo MSMaiken Nordahl SelsethAkershus University Hospital KLKristin Tveitan LarsenOslo University Hospital

Discussion

Member takes

Implication

Retrospective validation study evaluates prehospital scale accuracy for detecting large-vessel occlusion in stroke patients, suggesting limitations in clinical use.

Key Points

Assess the diagnostic performance of prehospital scales for detecting large-vessel occlusion in stroke patients.
Retrospective analysis of 1150 patients under stroke code protocol (2015-2017).
Evaluation of 55 scale-threshold combinations for computed tomography angiography-confirmed large-vessel occlusion detection.
Quantified accuracy using area under the receiver operating characteristic curve, sensitivity, specificity, and predictive values.
Large-vessel occlusion prevalence was 13.5%.
AUC ranged from 0.586 to 0.855; no scale surpassed the NIHSS after correction (AUC 0.851).
Accuracy varied with stroke laterality and age, with left-hemispheric strokes and older patients showing better AUC.

Cite This Study

Jahr et al. (2026) studied this question.

synapsesocial.com/papers/6a363274db0793dc1a539094 https://doi.org/10.1093/esj/aakag067

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