Cincinnati Prehospital Stroke Scale: Reproducibility and Validity
Study objective: The Cincinnati Prehospital Stroke Scale (CPSS) is a 3-item scale based on a simplification of the National Institutes of Health (NIH) Stroke Scale. When performed by a physician, it has a high sensitivity and specificity in identifying patients with stroke who are candidates for thr...
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| Veröffentlicht in: | Annals of emergency medicine 1999-04, Vol.33 (4), p.373-378 |
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| creator | Kothari, Rashmi U Pancioli, Arthur Liu, Tiepu Brott, Thomas Broderick, Joseph |
| description | Study objective: The Cincinnati Prehospital Stroke Scale (CPSS) is a 3-item scale based on a simplification of the National Institutes of Health (NIH) Stroke Scale. When performed by a physician, it has a high sensitivity and specificity in identifying patients with stroke who are candidates for thrombolysis. The objective of this study was to validate and verify the reproducibility of the CPSS when used by prehospital providers.
Methods: The CPSS was performed and scored by a physician certified in the use of the NIH Stroke Scale (gold standard). Simultaneously, a group of 4 paramedics and EMTs scored the same patient.
Results: A total of 860 scales were completed on a convenience sample of 171 patients from the emergency department and neurology inpatient service. Of these patients, 49 had a diagnosis of stroke or transient ischemic attack. High reproducibility was observed among prehospital providers for total score (intraclass correlation coefficient [r
I], .89; 95% confidence interval [CI], .87 to .92) and for each scale item: arm weakness, speech, and facial droop (.91, .84, and .75, respectively). There was excellent intraclass correlation between the physician and the prehospital providers for total score (r
I, .92; 95% CI, .89 to .93) and for the specific items of the scale (.91, .87, and .78, respectively). Observation by the physician of an abnormality in any 1 of the 3 stroke scale items had a sensitivity of 66% and specificity of 87% in identifying a stroke patient. The sensitivity was 88% for identification of patients with anterior circulation strokes.
Conclusion: The CPSS has excellent reproducibility among prehospital personnel and physicians. It has good validity in identifying patients with stroke who are candidates for thrombolytic therapy, especially those with anterior circulation stroke. [Kothari RU, Pancioli A, Liu T, Brott T, Broderick J: Cincinnati Prehospital Stroke Scale: Reproducibility and validity.
Ann Emerg Med April 1999;33:373-378.] |
| doi_str_mv | 10.1016/S0196-0644(99)70299-4 |
| format | Article |
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Methods: The CPSS was performed and scored by a physician certified in the use of the NIH Stroke Scale (gold standard). Simultaneously, a group of 4 paramedics and EMTs scored the same patient.
Results: A total of 860 scales were completed on a convenience sample of 171 patients from the emergency department and neurology inpatient service. Of these patients, 49 had a diagnosis of stroke or transient ischemic attack. High reproducibility was observed among prehospital providers for total score (intraclass correlation coefficient [r
I], .89; 95% confidence interval [CI], .87 to .92) and for each scale item: arm weakness, speech, and facial droop (.91, .84, and .75, respectively). There was excellent intraclass correlation between the physician and the prehospital providers for total score (r
I, .92; 95% CI, .89 to .93) and for the specific items of the scale (.91, .87, and .78, respectively). Observation by the physician of an abnormality in any 1 of the 3 stroke scale items had a sensitivity of 66% and specificity of 87% in identifying a stroke patient. The sensitivity was 88% for identification of patients with anterior circulation strokes.
Conclusion: The CPSS has excellent reproducibility among prehospital personnel and physicians. It has good validity in identifying patients with stroke who are candidates for thrombolytic therapy, especially those with anterior circulation stroke. [Kothari RU, Pancioli A, Liu T, Brott T, Broderick J: Cincinnati Prehospital Stroke Scale: Reproducibility and validity.
Ann Emerg Med April 1999;33:373-378.]</description><identifier>ISSN: 0196-0644</identifier><identifier>EISSN: 1097-6760</identifier><identifier>DOI: 10.1016/S0196-0644(99)70299-4</identifier><identifier>PMID: 10092713</identifier><identifier>CODEN: AEMED3</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Biological and medical sciences ; Cerebrovascular Disorders - classification ; Cerebrovascular Disorders - diagnosis ; Cerebrovascular Disorders - drug therapy ; Emergency Medical Services ; Female ; Humans ; Ischemic Attack, Transient - classification ; Ischemic Attack, Transient - diagnosis ; Ischemic Attack, Transient - drug therapy ; Male ; Medical sciences ; Middle Aged ; Neurology ; Observer Variation ; Prognosis ; Reproducibility of Results ; Severity of Illness Index ; Thrombolytic Therapy ; Treatment Outcome ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Annals of emergency medicine, 1999-04, Vol.33 (4), p.373-378</ispartof><rights>1999 American College of Emergency Physicians</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-5385d1dee8887bba7828cd47fb2bb6aa462c44cdd6706e5131db7f278e1a8a223</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0196064499702994$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1735331$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10092713$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kothari, Rashmi U</creatorcontrib><creatorcontrib>Pancioli, Arthur</creatorcontrib><creatorcontrib>Liu, Tiepu</creatorcontrib><creatorcontrib>Brott, Thomas</creatorcontrib><creatorcontrib>Broderick, Joseph</creatorcontrib><title>Cincinnati Prehospital Stroke Scale: Reproducibility and Validity</title><title>Annals of emergency medicine</title><addtitle>Ann Emerg Med</addtitle><description>Study objective: The Cincinnati Prehospital Stroke Scale (CPSS) is a 3-item scale based on a simplification of the National Institutes of Health (NIH) Stroke Scale. When performed by a physician, it has a high sensitivity and specificity in identifying patients with stroke who are candidates for thrombolysis. The objective of this study was to validate and verify the reproducibility of the CPSS when used by prehospital providers.
Methods: The CPSS was performed and scored by a physician certified in the use of the NIH Stroke Scale (gold standard). Simultaneously, a group of 4 paramedics and EMTs scored the same patient.
Results: A total of 860 scales were completed on a convenience sample of 171 patients from the emergency department and neurology inpatient service. Of these patients, 49 had a diagnosis of stroke or transient ischemic attack. High reproducibility was observed among prehospital providers for total score (intraclass correlation coefficient [r
I], .89; 95% confidence interval [CI], .87 to .92) and for each scale item: arm weakness, speech, and facial droop (.91, .84, and .75, respectively). There was excellent intraclass correlation between the physician and the prehospital providers for total score (r
I, .92; 95% CI, .89 to .93) and for the specific items of the scale (.91, .87, and .78, respectively). Observation by the physician of an abnormality in any 1 of the 3 stroke scale items had a sensitivity of 66% and specificity of 87% in identifying a stroke patient. The sensitivity was 88% for identification of patients with anterior circulation strokes.
Conclusion: The CPSS has excellent reproducibility among prehospital personnel and physicians. It has good validity in identifying patients with stroke who are candidates for thrombolytic therapy, especially those with anterior circulation stroke. [Kothari RU, Pancioli A, Liu T, Brott T, Broderick J: Cincinnati Prehospital Stroke Scale: Reproducibility and validity.
Ann Emerg Med April 1999;33:373-378.]</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cerebrovascular Disorders - classification</subject><subject>Cerebrovascular Disorders - diagnosis</subject><subject>Cerebrovascular Disorders - drug therapy</subject><subject>Emergency Medical Services</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemic Attack, Transient - classification</subject><subject>Ischemic Attack, Transient - diagnosis</subject><subject>Ischemic Attack, Transient - drug therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Observer Variation</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>Thrombolytic Therapy</subject><subject>Treatment Outcome</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0196-0644</issn><issn>1097-6760</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LAzEQhoMotlZ_grIHET2sJtlsPrxIKX6BoFj1GrLJLEa3uzXZCv57oy3qzdPMwDMzLw9CuwQfE0z4yRQTxXPMGTtU6khgqlTO1tCQYCVyLjheR8MfZIC2YnzBGCtGySYakNRRQYohGk98a33bmt5ndwGeuzj3vWmyaR-6V8im1jRwmt3DPHRuYX3lG99_ZKZ12ZNpvEvDNtqoTRNhZ1VH6PHi_GFyld_cXl5Pxje5LbHs87KQpSMOQEopqsoISaV1TNQVrSpuDOPUMmad4wJzKElBXCVqKiQQIw2lxQgdLO-mKG8LiL2e-WihaUwL3SJqrjhTlOIElkvQhi7GALWeBz8z4UMTrL_c6W93-kuMVkp_u9Ms7e2tHiyqGbg_W0tZCdhfASYmL3UwSV385URRFgVJ2NkSg2Tj3UPQ0XpoLTgfwPbadf6fJJ-hc4r9</recordid><startdate>19990401</startdate><enddate>19990401</enddate><creator>Kothari, Rashmi U</creator><creator>Pancioli, Arthur</creator><creator>Liu, Tiepu</creator><creator>Brott, Thomas</creator><creator>Broderick, Joseph</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990401</creationdate><title>Cincinnati Prehospital Stroke Scale: Reproducibility and Validity</title><author>Kothari, Rashmi U ; Pancioli, Arthur ; Liu, Tiepu ; Brott, Thomas ; Broderick, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-5385d1dee8887bba7828cd47fb2bb6aa462c44cdd6706e5131db7f278e1a8a223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cerebrovascular Disorders - classification</topic><topic>Cerebrovascular Disorders - diagnosis</topic><topic>Cerebrovascular Disorders - drug therapy</topic><topic>Emergency Medical Services</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemic Attack, Transient - classification</topic><topic>Ischemic Attack, Transient - diagnosis</topic><topic>Ischemic Attack, Transient - drug therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Observer Variation</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><topic>Thrombolytic Therapy</topic><topic>Treatment Outcome</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kothari, Rashmi U</creatorcontrib><creatorcontrib>Pancioli, Arthur</creatorcontrib><creatorcontrib>Liu, Tiepu</creatorcontrib><creatorcontrib>Brott, Thomas</creatorcontrib><creatorcontrib>Broderick, Joseph</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kothari, Rashmi U</au><au>Pancioli, Arthur</au><au>Liu, Tiepu</au><au>Brott, Thomas</au><au>Broderick, Joseph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cincinnati Prehospital Stroke Scale: Reproducibility and Validity</atitle><jtitle>Annals of emergency medicine</jtitle><addtitle>Ann Emerg Med</addtitle><date>1999-04-01</date><risdate>1999</risdate><volume>33</volume><issue>4</issue><spage>373</spage><epage>378</epage><pages>373-378</pages><issn>0196-0644</issn><eissn>1097-6760</eissn><coden>AEMED3</coden><abstract>Study objective: The Cincinnati Prehospital Stroke Scale (CPSS) is a 3-item scale based on a simplification of the National Institutes of Health (NIH) Stroke Scale. When performed by a physician, it has a high sensitivity and specificity in identifying patients with stroke who are candidates for thrombolysis. The objective of this study was to validate and verify the reproducibility of the CPSS when used by prehospital providers.
Methods: The CPSS was performed and scored by a physician certified in the use of the NIH Stroke Scale (gold standard). Simultaneously, a group of 4 paramedics and EMTs scored the same patient.
Results: A total of 860 scales were completed on a convenience sample of 171 patients from the emergency department and neurology inpatient service. Of these patients, 49 had a diagnosis of stroke or transient ischemic attack. High reproducibility was observed among prehospital providers for total score (intraclass correlation coefficient [r
I], .89; 95% confidence interval [CI], .87 to .92) and for each scale item: arm weakness, speech, and facial droop (.91, .84, and .75, respectively). There was excellent intraclass correlation between the physician and the prehospital providers for total score (r
I, .92; 95% CI, .89 to .93) and for the specific items of the scale (.91, .87, and .78, respectively). Observation by the physician of an abnormality in any 1 of the 3 stroke scale items had a sensitivity of 66% and specificity of 87% in identifying a stroke patient. The sensitivity was 88% for identification of patients with anterior circulation strokes.
Conclusion: The CPSS has excellent reproducibility among prehospital personnel and physicians. It has good validity in identifying patients with stroke who are candidates for thrombolytic therapy, especially those with anterior circulation stroke. [Kothari RU, Pancioli A, Liu T, Brott T, Broderick J: Cincinnati Prehospital Stroke Scale: Reproducibility and validity.
Ann Emerg Med April 1999;33:373-378.]</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>10092713</pmid><doi>10.1016/S0196-0644(99)70299-4</doi><tpages>6</tpages></addata></record> |
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| ispartof | Annals of emergency medicine, 1999-04, Vol.33 (4), p.373-378 |
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| subjects | Aged Biological and medical sciences Cerebrovascular Disorders - classification Cerebrovascular Disorders - diagnosis Cerebrovascular Disorders - drug therapy Emergency Medical Services Female Humans Ischemic Attack, Transient - classification Ischemic Attack, Transient - diagnosis Ischemic Attack, Transient - drug therapy Male Medical sciences Middle Aged Neurology Observer Variation Prognosis Reproducibility of Results Severity of Illness Index Thrombolytic Therapy Treatment Outcome Vascular diseases and vascular malformations of the nervous system |
| title | Cincinnati Prehospital Stroke Scale: Reproducibility and Validity |
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