Screening: 3 Easy Steps to Diagnose Strokes

By JOHN O'NEIL

NY Times, February 18, 2003

People who are coached to give a three-step test can accurately tell if someone is having a stroke, a new study has found.

Rapid diagnosis of strokes is especially important because the clot-busting drugs that can reverse or limit brain damage can be used only in the first few hours after strokes occur.

The study was presented last week at a conference of the American Stroke Association in Phoenix. Researchers from the University of North Carolina-Chapel Hill School of Medicine enlisted six stroke survivors who still had some symptoms to test how well 100 volunteers could use the test.

Researchers acting the part of 911 operators talked the volunteers through the three steps: asking the patients to smile broadly, showing their teeth; to close their eyes, raise their arms in front of them and hold them out for a count of 10; and to repeat a simple phrase.

One researcher, Amy S. Hurwitz, a second-year medical student, said the tests took only about a minute to conduct.

The volunteers, she said, did well: they were 97 percent accurate in detecting arm weakness and 96 percent accurate in detecting speech deficits. But they were right only 74 percent of the time when it came to detecting facial weakness, probably because it is hard to assess a stranger's smile, Ms. Hurwitz said.

The test was developed for health care workers, but Ms. Hurwitz said that anyone familiar with the procedure could help diagnose a stroke.