Feb. 13, 2003 (Phoenix) -- A team of stroke
researchers has devised a one-minute test that can be used by ordinary people
to diagnose stroke -- and the test is so simple that even a child can use it.
Such an easy, quick test could potentially save thousands of stroke sufferers
from the disabling effects by allowing faster treatment.
"It is just three simple steps" says Jane Brice, MD, assistant
professor of emergency medicine at the University of North Carolina-Chapel Hill
School of Medicine. Brice tells WebMD that the test is based on a scale
developed by researchers at the University of Cincinnati. The three-part test,
called the Cincinnati Pre-Hospital Stroke Scale (CPSS), can be used to diagnose
most strokes, says Brice.
Brice and her colleagues measured the accuracy of the test by
first teaching it to 100 healthy bystanders. The bystanders then performed the
test on stroke survivors. To diagnose a stroke, the bystanders performed the
following three steps:
1. Bystander told the patients, "Show me your teeth." The
"smile test" is used to check for one-sided facial weakness -- a classic sign
2. Then the patients were told to close their eyes and raise
their arms. Stroke patients usually cannot raise both arms to the same height,
a sign of arm weakness.
3. Finally, the patients were asked to repeat a simple sentence
to check for slurring of speech, which is another classic sign of stroke. "In
Cincinnati, the researchers asked patients to say, 'The sky is blue in
Cincinnati,'" says Brice. But in the study, the researchers varied four simple
phrases such as "Don't cry over spilled milk."
Overall, 97% of the bystanders were able to accurately follow
the directions for giving the test, says Amy S. Hurwitz, a medical student at
UNC who helped design the study.
The bystanders were 96% accurate at detecting speech problems
and 97% accurate at spotting one-sided arm weakness. They were less accurate at
detecting facial weakness -- with only a 72% accuracy rate for this test. But
Hurwitz says, "It is difficult to detect differences in the smile of a
stranger. We are hoping that in most cases the 'bystander' will actually be
someone who knows the patient and so an unusual smile will be apparent."
"This is all about time," says Edgar J. Kenton III, professor
of clinical neurology at Thomas Jefferson University in Wynnewood, Pa. Kenton,
who wasn't involved in the study, says that clot-busting drugs used to treat most strokes can only be given
within the first three hours after a stroke. Thus, he and other stroke
specialists constantly seek ways to speed treatment.
"This is so simple that even a child could use it. Look at how
many children have saved their parents by doing CPR, and this is so much
simpler," says Kenton. He says he thinks the test should be promoted for use by
the general public.
Brice agrees with this assessment, saying that it could be like
the Stop, Drop and Roll campaign to avoid burn injuries. "We call it: Talk,
SOURCES: American Stroke Association 28th International Stroke Conference.
Jane Brice, MD, assistant professor of emergency medicine, University of North
Carolina-Chapel Hill School of Medicine. Amy S. Hurwitz, medical student,
University of North Carolina-Chapel Hill. Edgar J. Kenton III, professor of
clinical neurology, Thomas Jefferson University, Wynnewood, Pa.