Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE
Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0...
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Veröffentlicht in: | Stroke (1970) 2024-09, Vol.55 (9), p.2240-2246 |
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creator | Turón-Viñas, Eulàlia Boronat, Susana Gich, Ignasi González Álvarez, Verónica García-Puig, Montserrat Camós Carreras, Maria Rodriguez-Palmero, Agustí Felipe-Rucián, Ana Aznar-Laín, Gemma Jiménez-Fàbrega, Xavier Pérez de la Ossa, Natalia |
description | Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0-2; arm motor function 0-2; leg motor function 0-2; head/gaze deviation 0-1; and aphasia or agnosia 0-2), has good sensitivity and specificity in detecting large vessel occlusion.
We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability.
The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852; |
doi_str_mv | 10.1161/STROKEAHA.124.046846 |
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We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability.
The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852;
<0.001) and prehospital/emergency staff (Spearman ρ, 0.781;
<0.001). The median Pediatric RACE score was significantly higher in patients with large vessel occlusion (6.5; interquartile range, 6-7) than with other etiologies.
Pediatric RACE, showing good interrater reliability and correlation with the Pediatric National Institutes of Health Stroke Scale, is a simple scale to detect candidates for pediatric acute stroke treatment, designed for both prehospital and in-hospital use by non-neurologist medical staff.</description><identifier>ISSN: 0039-2499</identifier><identifier>ISSN: 1524-4628</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.124.046846</identifier><identifier>PMID: 39051112</identifier><language>eng</language><publisher>United States</publisher><ispartof>Stroke (1970), 2024-09, Vol.55 (9), p.2240-2246</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c186t-2e2e291f3e15f41d9871ef50f40ecc415ac3695259d0bbeb3feb68e9713831ec3</cites><orcidid>0000-0002-6468-1939 ; 0000-0001-6171-0282 ; 0009-0003-5488-8789 ; 0009-0006-0651-3626 ; 0000-0001-8720-1865 ; 0000-0002-4141-5515 ; 0000-0002-6063-211X ; 0000-0002-5267-1370</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39051112$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Turón-Viñas, Eulàlia</creatorcontrib><creatorcontrib>Boronat, Susana</creatorcontrib><creatorcontrib>Gich, Ignasi</creatorcontrib><creatorcontrib>González Álvarez, Verónica</creatorcontrib><creatorcontrib>García-Puig, Montserrat</creatorcontrib><creatorcontrib>Camós Carreras, Maria</creatorcontrib><creatorcontrib>Rodriguez-Palmero, Agustí</creatorcontrib><creatorcontrib>Felipe-Rucián, Ana</creatorcontrib><creatorcontrib>Aznar-Laín, Gemma</creatorcontrib><creatorcontrib>Jiménez-Fàbrega, Xavier</creatorcontrib><creatorcontrib>Pérez de la Ossa, Natalia</creatorcontrib><creatorcontrib>Catalan Pediatric Stroke Study Group</creatorcontrib><title>Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0-2; arm motor function 0-2; leg motor function 0-2; head/gaze deviation 0-1; and aphasia or agnosia 0-2), has good sensitivity and specificity in detecting large vessel occlusion.
We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability.
The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852;
<0.001) and prehospital/emergency staff (Spearman ρ, 0.781;
<0.001). The median Pediatric RACE score was significantly higher in patients with large vessel occlusion (6.5; interquartile range, 6-7) than with other etiologies.
Pediatric RACE, showing good interrater reliability and correlation with the Pediatric National Institutes of Health Stroke Scale, is a simple scale to detect candidates for pediatric acute stroke treatment, designed for both prehospital and in-hospital use by non-neurologist medical staff.</description><issn>0039-2499</issn><issn>1524-4628</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNo9kEFPwkAQhTdGI4j-A2N69FLc2d22u94IohBJMAW8NtvtVNeUFnfLgX9vCUheMnOY9-YlHyH3QIcAMTwtV-nifTKajobAxJCKWIr4gvQhYiIUMZOXpE8pVyETSvXIjfc_lFLGZXRNelzRCABYn6xf0NuvOtB1EczqFp3T3QhSrKzObWXbfdCUQfuNwQcWVrfOmuATnbdN_X9ItcFgaXSFzwdTOhpPbslVqSuPd6c9IOvXyWo8DeeLt9l4NA8NyLgNGXZSUHKEqBRQKJkAlhEtBUVjBETa8FhFLFIFzXPMeYl5LFElwCUHNHxAHo9_t6753aFvs431BqtK19jsfMapFEnCodOAiKPVuMZ7h2W2dXaj3T4Dmh2AZmegWQc0OwLtYg-nhl2-weIc-ifI_wBtwHDF</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Turón-Viñas, Eulàlia</creator><creator>Boronat, Susana</creator><creator>Gich, Ignasi</creator><creator>González Álvarez, Verónica</creator><creator>García-Puig, Montserrat</creator><creator>Camós Carreras, Maria</creator><creator>Rodriguez-Palmero, Agustí</creator><creator>Felipe-Rucián, Ana</creator><creator>Aznar-Laín, Gemma</creator><creator>Jiménez-Fàbrega, Xavier</creator><creator>Pérez de la Ossa, Natalia</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6468-1939</orcidid><orcidid>https://orcid.org/0000-0001-6171-0282</orcidid><orcidid>https://orcid.org/0009-0003-5488-8789</orcidid><orcidid>https://orcid.org/0009-0006-0651-3626</orcidid><orcidid>https://orcid.org/0000-0001-8720-1865</orcidid><orcidid>https://orcid.org/0000-0002-4141-5515</orcidid><orcidid>https://orcid.org/0000-0002-6063-211X</orcidid><orcidid>https://orcid.org/0000-0002-5267-1370</orcidid></search><sort><creationdate>20240901</creationdate><title>Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE</title><author>Turón-Viñas, Eulàlia ; Boronat, Susana ; Gich, Ignasi ; González Álvarez, Verónica ; García-Puig, Montserrat ; Camós Carreras, Maria ; Rodriguez-Palmero, Agustí ; Felipe-Rucián, Ana ; Aznar-Laín, Gemma ; Jiménez-Fàbrega, Xavier ; Pérez de la Ossa, Natalia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c186t-2e2e291f3e15f41d9871ef50f40ecc415ac3695259d0bbeb3feb68e9713831ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Turón-Viñas, Eulàlia</creatorcontrib><creatorcontrib>Boronat, Susana</creatorcontrib><creatorcontrib>Gich, Ignasi</creatorcontrib><creatorcontrib>González Álvarez, Verónica</creatorcontrib><creatorcontrib>García-Puig, Montserrat</creatorcontrib><creatorcontrib>Camós Carreras, Maria</creatorcontrib><creatorcontrib>Rodriguez-Palmero, Agustí</creatorcontrib><creatorcontrib>Felipe-Rucián, Ana</creatorcontrib><creatorcontrib>Aznar-Laín, Gemma</creatorcontrib><creatorcontrib>Jiménez-Fàbrega, Xavier</creatorcontrib><creatorcontrib>Pérez de la Ossa, Natalia</creatorcontrib><creatorcontrib>Catalan Pediatric Stroke Study Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Turón-Viñas, Eulàlia</au><au>Boronat, Susana</au><au>Gich, Ignasi</au><au>González Álvarez, Verónica</au><au>García-Puig, Montserrat</au><au>Camós Carreras, Maria</au><au>Rodriguez-Palmero, Agustí</au><au>Felipe-Rucián, Ana</au><au>Aznar-Laín, Gemma</au><au>Jiménez-Fàbrega, Xavier</au><au>Pérez de la Ossa, Natalia</au><aucorp>Catalan Pediatric Stroke Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>55</volume><issue>9</issue><spage>2240</spage><epage>2246</epage><pages>2240-2246</pages><issn>0039-2499</issn><issn>1524-4628</issn><eissn>1524-4628</eissn><abstract>Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0-2; arm motor function 0-2; leg motor function 0-2; head/gaze deviation 0-1; and aphasia or agnosia 0-2), has good sensitivity and specificity in detecting large vessel occlusion.
We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability.
The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852;
<0.001) and prehospital/emergency staff (Spearman ρ, 0.781;
<0.001). The median Pediatric RACE score was significantly higher in patients with large vessel occlusion (6.5; interquartile range, 6-7) than with other etiologies.
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title | Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE |
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