Sensibilidad y especificidad de las escalas de predicción de RACE y CPSS. Revisión sistemática

Abstract

This study addresses the challenges of diagnosing ischemic stroke (AIS) in resource-limited clinical settings, where the Rapid Arterial Occlusion Evaluation (RACE) and Cincinnati Prehospital Stroke Scale (CPSS) scales serve as essential tools. It aimed to compare the sensitivity and specificity of these two scales through a systematic review of recent studies. The methodology followed the PRISMA model, including clinical trials and observational studies published in English or Spanish. Results revealed notable variability: CPSS demonstrated greater consistency in sensitivity, while RACE excelled in specificity. The positive predictive value of CPSS ranged from 22% to 98%, while RACE's was between 28% and 93%. Regarding negative predictive value, RACE performed more uniformly (60%- 100%) than CPSS (23%- 96%). Likelihood ratios (LR) indicated that RACE might be more effective in excluding AIS in negative cases. In conclusion, while both scales have advantages, CPSS is more suitable for early detection due to its higher sensitivity. In contrast, RACE is more helpful in confirming suspected cases due to its specificity. Additional studies are recommended to standardize their use and assess their impact on clinical practice and long-term outcomes. Keywords: CPSS, RACE, sensitivity, specificity, predictive value