The value of the Frenchay Aphasia Screening Test in screening for dysphasia: better than the clinician?

We have evaluated the Frenchay Aphasia Screening Test (FAST) in an elderly population living in the community, and in patients with a first stroke. Fifty-one elderly people aged 69-90 years were screened. Ten subjects failed the test (score < 25/30). There was an inverse relationship between age and the FAST score ( r s = -0.35, p = 0.02, 95% Cl 0.09-0.57). I n a group of 82 elderly patients, mean age 80 (6 years), admitted with a first stroke, the FAST was applied at one and seven days and the result compared with a clinical assessment and a speech therapy assessment. At day one 28 patients failed the test due to a reduced level of consciousness. The use of the FAST increased the sensitivity of screening from 87% to 96%, but reduced its specificity from 100% to 61 %. The positive and negative predictive values were 65% and 95% respectively.