Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysis
Introduction Los Angeles Motor Scale (LAMS) is a validated prehospital scoring tool to identify stroke patients with large vessel occlusions (LVOs). While some studies have reported conflicting data in regards to the diagnostic value of LAMS, this systematic review and meta-analysis aims to prov...
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2023-04-01
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| Series: | طب اورژانس ایران |
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| Online Access: | https://journals.sbmu.ac.ir/iranjem/article/view/41427 |
| _version_ | 1797836762989461504 |
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| author | Koohyar Ahmadzadeh Erfan Abdollahi Mohsen Aliyariparand Mohammad Soleimani Hamzah Adel Ramawad Reza Miri Mahmoud Yousefifard |
| author_facet | Koohyar Ahmadzadeh Erfan Abdollahi Mohsen Aliyariparand Mohammad Soleimani Hamzah Adel Ramawad Reza Miri Mahmoud Yousefifard |
| author_sort | Koohyar Ahmadzadeh |
| collection | DOAJ |
| description |
Introduction
Los Angeles Motor Scale (LAMS) is a validated prehospital scoring tool to identify stroke patients with large vessel occlusions (LVOs). While some studies have reported conflicting data in regards to the diagnostic value of LAMS, this systematic review and meta-analysis aims to provide a more concrete evidence for the value of this clinical decision tool in the diagnosis of LVO in suspected stroke patients.
Method
Online databases of PubMed, Embase, Scopus, and Web of Science were searched until the end of October 2022, for studies evaluating the diagnostic performance of LAMS in the detection of LVOs in suspected stroke patients.
Results
The results of our analysis demonstrated an AUC of 0.83 (95% CI: 0.79, 0.86), sensitivity of 0.65 (95% CI: 0.54, 0.74), and specificity of 0.83 (95% CI: 0.79, 0.86) for the diagnostic value of LAMS score with a cut-off value of ≥ 4. The diagnostic odds ratio of LAMS score was 8.81 (95% CI: 6.24, 12.45). Sensitivity analyses reveled that diagnostic performance of LAMS improves when utilized for detection of occlusion in the more proximal segments of large vessels, with a sensitivity of 0.75 and specificity of 0.83.
Conclusion
A high level of evidence showed that LAMS scale does not have a promising diagnostic value in the identification of LVOs in suspected stroke patients. The sensitivity of 0.65 for this tool makes it obsolete as a proper triaging tool. As a suggestion, LAMS could be utilized in conjunction with other additional factors to increase its diagnostic performance.
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| first_indexed | 2024-04-09T15:14:09Z |
| format | Article |
| id | doaj.art-9be35fcecd934b2e89dcfa1054de890c |
| institution | Directory Open Access Journal |
| issn | 2383-3645 |
| language | English |
| last_indexed | 2024-04-09T15:14:09Z |
| publishDate | 2023-04-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | طب اورژانس ایران |
| spelling | doaj.art-9be35fcecd934b2e89dcfa1054de890c2023-04-30T06:26:26ZengShahid Beheshti University of Medical Sciencesطب اورژانس ایران2383-36452023-04-0110110.22037/ijem.v10i1.41427Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysisKoohyar Ahmadzadeh0Erfan Abdollahi1Mohsen Aliyariparand2Mohammad Soleimani3Hamzah Adel Ramawad4Reza Miri5Mahmoud Yousefifard6Physiology Research Center, Iran University of Medical Sciences, Tehran, IranPhysiology Research Center, Iran University of Medical Sciences, Tehran, IranPhysiology Research Center, Iran University of Medical Sciences, Tehran, IranPhysiology Research Center, Iran University of Medical Sciences, Tehran, IranPhysiology Research Center, Iran University of Medical Sciences, Tehran, IranPhysiology Research Center, Iran University of Medical Sciences, Tehran, IranPhD, Assistant Prof. of Physiology; Physiology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Introduction Los Angeles Motor Scale (LAMS) is a validated prehospital scoring tool to identify stroke patients with large vessel occlusions (LVOs). While some studies have reported conflicting data in regards to the diagnostic value of LAMS, this systematic review and meta-analysis aims to provide a more concrete evidence for the value of this clinical decision tool in the diagnosis of LVO in suspected stroke patients. Method Online databases of PubMed, Embase, Scopus, and Web of Science were searched until the end of October 2022, for studies evaluating the diagnostic performance of LAMS in the detection of LVOs in suspected stroke patients. Results The results of our analysis demonstrated an AUC of 0.83 (95% CI: 0.79, 0.86), sensitivity of 0.65 (95% CI: 0.54, 0.74), and specificity of 0.83 (95% CI: 0.79, 0.86) for the diagnostic value of LAMS score with a cut-off value of ≥ 4. The diagnostic odds ratio of LAMS score was 8.81 (95% CI: 6.24, 12.45). Sensitivity analyses reveled that diagnostic performance of LAMS improves when utilized for detection of occlusion in the more proximal segments of large vessels, with a sensitivity of 0.75 and specificity of 0.83. Conclusion A high level of evidence showed that LAMS scale does not have a promising diagnostic value in the identification of LVOs in suspected stroke patients. The sensitivity of 0.65 for this tool makes it obsolete as a proper triaging tool. As a suggestion, LAMS could be utilized in conjunction with other additional factors to increase its diagnostic performance. https://journals.sbmu.ac.ir/iranjem/article/view/41427StrokeLarge vessel occlusionclinical decision toolLos Angeles Motor Scale |
| spellingShingle | Koohyar Ahmadzadeh Erfan Abdollahi Mohsen Aliyariparand Mohammad Soleimani Hamzah Adel Ramawad Reza Miri Mahmoud Yousefifard Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysis طب اورژانس ایران Stroke Large vessel occlusion clinical decision tool Los Angeles Motor Scale |
| title | Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysis |
| title_full | Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysis |
| title_fullStr | Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysis |
| title_full_unstemmed | Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysis |
| title_short | Value of Los Angeles Motor Scale (LAMS) in the detection of large vessels occlusion in suspected stroke patients; a systematic review and meta-analysis |
| title_sort | value of los angeles motor scale lams in the detection of large vessels occlusion in suspected stroke patients a systematic review and meta analysis |
| topic | Stroke Large vessel occlusion clinical decision tool Los Angeles Motor Scale |
| url | https://journals.sbmu.ac.ir/iranjem/article/view/41427 |
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