Recognition of Stroke in the Emergency Room (ROSIER) Scale in Identifying Strokes and Transient Ischemic Attacks (TIAs); a Systematic Review and Meta-Analysis.

Introduction: A range of screening tools has been developed to assist emergency healthcare providers in rapidly and accurately diagnosing strokes. In this study, we investigated the diagnostic value of the Recognition of Stroke in the Emergency Room (ROSIER) scale in identifying individuals with str...

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Publicado en:Archives of Academic Emergency Medicine Vol. 11; no. 1; pp. 1 - 16
Autores principales: Rad, Iman Chehregani, Azimi, Amir
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Shahid Beheshti University of Medical Sciences 2023
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Recognition of Stroke in the Emergency Room (ROSIER) Scale in Identifying Strokes and Transient Ischemic Attacks (TIAs); a Systematic Review and Meta-Analysis.
      aug:
        au:
          Rad, Iman Chehregani
          Azimi, Amir
        affil: Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
      sug:
        subj:
          Stroke Diagnosis
          Emergency Service
          Cerebral Ischemia, Transient Diagnosis
          Human
          Systematic Review
          PubMed
          Embase
          Sensitivity and Specificity
          Confidence Intervals
          Odds Ratio
          ROC Curve
          Data Analysis Software
          Descriptive Statistics
          Quality Assessment
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Stroke Patients
          Health Personnel
          Meta Analysis
          Scales
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Introduction: A range of screening tools has been developed to assist emergency healthcare providers in rapidly and accurately diagnosing strokes. In this study, we investigated the diagnostic value of the Recognition of Stroke in the Emergency Room (ROSIER) scale in identifying individuals with stroke and transient ischemic attack (TIA). Methods: We conducted a systematic search across online databases of PubMed, Embase, Scopus, and Web of Science until June 12th, 2023, aiming to identify studies that assessed the diagnostic performance of the ROSIER scale in detecting strokes and TIAs among individuals with suspected stroke symptoms. Results: Data extracted from 34 studies were analyzed, demonstrating that the ROSIER score, with a cut-off value of ≥ 1, has sensitivity of 0.89 (95% confidence interval (CI): 0.86-0.92), specificity of 0.76 (95% CI: 0.69-0.81), diagnostic odds ratio (DOR) of 25.41 (95% CI: 17.2-37.54), and area under the curve (AUC) of 0.91 (95% CI: 0.85-0.90) in detection of strokes and TIAs. Meta-regression subgroup analysis revealed variations in sensitivity and specificity based on different settings and assessors. Sensitivity was higher in pre-hospital settings when the test was administered by emergency medical services (EMS) and emergency department (ED) paramedic staff, whereas specificity was higher in emergency department settings and when physicians and neurologists conducted the test. Conclusion: A moderate level of evidence shows that the ROSIER scale is considered an excellent tool for identifying strokes and TIAs. As a valid method for identifying strokes, it holds applicability across diverse settings and can be effectively used by assessors with different specialties.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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