The accuracy of CPSS, LAPSS and MASS in terms of early acute ischemic stroke diagnosis

Objective: In this study, we aimed to investigate the diagnostic accuracy of Cincinnati Prehospital Stroke Scale (CPSS), Los Angeles Prehospital Stroke Screen (LAPSS) and Melbourne Ambulance Stroke Scale (MASS) in detecting acute ischemic stroke (AIS) in suspected patients, and to compare these scales with each other.
Methods: This was a diagnostic accuracy study that included patients with suspected AIS brought to emergency department (ED). Patients’ data were collected from their medical records. Collected data from all tests were compared with the final diagnosis of AIS based on the brain MRI report. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were measured separately using statistical tests with confidence interval (CI) of 95%.
Results: Finally, 766 patients were included, of whom 57.6% were males. The mean age for the study population was 66.8 ± 13.7 years. All patients underwent brain MRI and the results showed that 537 patients (70.1%) had actual diagnosis of AIS. The accuracy of CPSS, MASS, LAPSS were 82.9%, 79.2% and 78.1%, respectively. However, in the present study, the differences between the sensitivity and specificity of these three scales were statistically significant (p < 0.001).
Conclusion: Our study showed that the number of true positive cases diagnosed by CPSS was higher than those of MASS, and MASS true positives were higher than those diagnosed by LAPSS criteria. The number of true negative cases of LAPSS was higher than MASS criteria, and MASS true negatives were higher than CPSS criteria.