Can the ROSIER scale diagnose patients with stroke accurately in the emergency department?
Larry B Goldstein
Correspondence Duke University Medical Center, Box 3651, Durham, NC 27710, USA
Email golds004@mc.duke.edu
This article has no abstract so we have provided the first paragraph of the full text.
Use of thrombolytic therapy is generally most appropriate in hospitals that have an organized approach to stroke care.1 The ROSIER scale was developed to facilitate rapid identification and triage of patients with stroke by emergency department physicians; however, is the use of the scale by emergency physicians clinically useful? As discussed by Sackett et al., the clinical usefulness of a diagnostic test (in this case the ROSIER scale) can be thought of as the capacity of the test to change our minds from what we thought before the test.2 This capacity of change is calculated as the difference between the 'pretest' probability (i.e. population prevalence) of the target disorder and the 'post-test' probability (calculated on the basis of the pretest odds and the likelihood ratio).2 As a rule, tests that lead to large changes from pretest to post-test probabilities are considered clinically useful.
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