The following is a summary of “External validation of Vision, Aphasia and Neglect, Ventura Emergent Large Vessel Occlusion and Large Artery Intracranial Occlusion screening tools for emergent large vessel occlusion stroke: A multicenter, prospective, cross-sectional study,” published in the August 2024 issue of Emergency Medicine by Özturan et al.

Vision, Aphasia, and Neglect (VAN), Ventura Emergent Large Vessel Occlusion (VES), and Large Artery Intracranial Occlusion (LARIO) stroke screening tools demonstrated high diagnostic accuracy in detecting Emergent Large Vessel Occlusion (ELVO) in initial studies.

Researchers conducted a prospective study to validate the predictive performance of VAN, VES, and LARIO for detecting ELVO in patients with suspected acute ischemic stroke at ED triage.

They conducted a multicenter study across 5 tertiary stroke center EDs (June to October 2023). Suspected patients with stroke were assessed using VAN, VES, and LARIO stroke screening tools. The diagnostic accuracy of the tools for predicting ELVO was compared to the National Institute of Health Stroke Scale (NIHSS).

The results showed that out of 614 patients, 23.5% had ELVO. The VAN had a sensitivity of 70.1% and a specificity of 78.7%, VES had a higher sensitivity of 79.1% but a lower specificity of 63.4%, and LARIO had a high specificity of 86% but a lower sensitivity of 56.3%. The ROC curve analysis indicated that LARIO and the National Institute of Health Stroke Scale (NIHSS) had comparable diagnostic performance (AUC 0.801 and 0.805, P=0.7), while VES performed slightly worse (AUC 0.746, P<0.001 and P=0.003).

Investigators concluded that VAN, VES, and LARIO’s comparable accuracy to the NIHSS, combined with the ease of use and rapid assessment, could enhance the timely management of patients with ELVO in pre-hospital or ED triage settings.

Source: jem-journal.com/article/S0736-4679(24)00232-4/abstract#%20