First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected stroke
Background Detecting an anterior circulation large-vessel occlusion (aLVO) as a cause of stroke during emergency calls could optimise dispatch, particularly in rural areas. Numerous stroke severity scales assessing motor and cortical signs have been designed for direct patient contact; however, none...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Neurology Open |
| Online Access: | https://neurologyopen.bmj.com/content/7/1/e000859.full |
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| author | Erik Farin-Glattacker Christian A Taschner Hans-Jörg Busch Wolf-Dirk Niesen Matthias L Herrmann Florian F Schuchardt Clara Franck Simone Meier Max Henningsen Friederike S Brohl Christoph Sonntag Nicole Wimmesberger Jochen Brich |
| author_facet | Erik Farin-Glattacker Christian A Taschner Hans-Jörg Busch Wolf-Dirk Niesen Matthias L Herrmann Florian F Schuchardt Clara Franck Simone Meier Max Henningsen Friederike S Brohl Christoph Sonntag Nicole Wimmesberger Jochen Brich |
| author_sort | Erik Farin-Glattacker |
| collection | DOAJ |
| description | Background Detecting an anterior circulation large-vessel occlusion (aLVO) as a cause of stroke during emergency calls could optimise dispatch, particularly in rural areas. Numerous stroke severity scales assessing motor and cortical signs have been designed for direct patient contact; however, none have been purposely designed for emergency calls. This study aimed to prospectively validate the novel Freiburg Neurointerventional Score (FRENS) in patients presenting with a suspected acute stroke to detect aLVO.Methods Patients aged ≥18 years with suspected acute stroke brought directly to our tertiary hospital by paramedics, between May 2021 and 2022, were included in this study. We used the FRENS and National Institutes of Health Stroke Scale (NIHSS) to analyse the FRENS convergent validity. We evaluated and compared the predictive ability and test characteristics of the FRENS and five established NIHSS-based stroke severity scales for the detection of an aLVO stroke. We analysed the number of steps required for the completion of the FRENS algorithm.Results Among the 1042 analysed patients, the FRENS items showed high convergent validity with corresponding NIHSS items. A positive FRENS was statistically significantly correlated with an aLVO stroke. The FRENS had the highest sensitivity and negative predictive values for an aLVO stroke and the highest sensitivity value for M2 occlusions. The FRENS provided results after two and all four steps, in 71% and <3% of cases, respectively.Conclusions The FRENS enabled the rapid, sensitive detection of an aLVO in patients with suspected acute stroke. Designed for use in emergency calls, the FRENS requires translation and validation in a prehospital setting. |
| format | Article |
| id | doaj-art-678108bbb476492c990a316a58dea8fe |
| institution | Kabale University |
| issn | 2632-6140 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Neurology Open |
| spelling | doaj-art-678108bbb476492c990a316a58dea8fe2025-02-04T16:45:10ZengBMJ Publishing GroupBMJ Neurology Open2632-61402025-02-017110.1136/bmjno-2024-000859First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected strokeErik Farin-Glattacker0Christian A Taschner1Hans-Jörg Busch2Wolf-Dirk Niesen3Matthias L Herrmann4Florian F Schuchardt5Clara Franck6Simone Meier7Max Henningsen8Friederike S Brohl9Christoph Sonntag10Nicole Wimmesberger11Jochen Brich12Section of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany3 Department of Neuroradiology, University of Freiburg Faculty of Medicine, Freiburg, Germany1Department of Medicine, Universitätsklinikum Freiburg i.Br., Freiburg i.Br., GermanyDepartment of Neurology and Neurophysiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Clinical Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Clinical Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanySection of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Clinical Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Clinical Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Clinical Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanySection of Health Care Research and Rehabilitation Research (SEVERA), Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyDepartment of Neurology and Clinical Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, GermanyBackground Detecting an anterior circulation large-vessel occlusion (aLVO) as a cause of stroke during emergency calls could optimise dispatch, particularly in rural areas. Numerous stroke severity scales assessing motor and cortical signs have been designed for direct patient contact; however, none have been purposely designed for emergency calls. This study aimed to prospectively validate the novel Freiburg Neurointerventional Score (FRENS) in patients presenting with a suspected acute stroke to detect aLVO.Methods Patients aged ≥18 years with suspected acute stroke brought directly to our tertiary hospital by paramedics, between May 2021 and 2022, were included in this study. We used the FRENS and National Institutes of Health Stroke Scale (NIHSS) to analyse the FRENS convergent validity. We evaluated and compared the predictive ability and test characteristics of the FRENS and five established NIHSS-based stroke severity scales for the detection of an aLVO stroke. We analysed the number of steps required for the completion of the FRENS algorithm.Results Among the 1042 analysed patients, the FRENS items showed high convergent validity with corresponding NIHSS items. A positive FRENS was statistically significantly correlated with an aLVO stroke. The FRENS had the highest sensitivity and negative predictive values for an aLVO stroke and the highest sensitivity value for M2 occlusions. The FRENS provided results after two and all four steps, in 71% and <3% of cases, respectively.Conclusions The FRENS enabled the rapid, sensitive detection of an aLVO in patients with suspected acute stroke. Designed for use in emergency calls, the FRENS requires translation and validation in a prehospital setting.https://neurologyopen.bmj.com/content/7/1/e000859.full |
| spellingShingle | Erik Farin-Glattacker Christian A Taschner Hans-Jörg Busch Wolf-Dirk Niesen Matthias L Herrmann Florian F Schuchardt Clara Franck Simone Meier Max Henningsen Friederike S Brohl Christoph Sonntag Nicole Wimmesberger Jochen Brich First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected stroke BMJ Neurology Open |
| title | First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected stroke |
| title_full | First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected stroke |
| title_fullStr | First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected stroke |
| title_full_unstemmed | First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected stroke |
| title_short | First validation of the novel Freiburg Neurointerventional Score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large-vessel occlusion in patients with suspected stroke |
| title_sort | first validation of the novel freiburg neurointerventional score purposely designed for use by emergency medical dispatchers for detecting anterior circulation large vessel occlusion in patients with suspected stroke |
| url | https://neurologyopen.bmj.com/content/7/1/e000859.full |
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