{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:35:45Z","timestamp":1790663745437,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,6,18]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Enhanced detection of large vessel occlusion (LVO) through machine learning (ML) for acute ischemic stroke appears promising. This systematic review explored the capabilities of ML models compared with prehospital stroke scales for LVO prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Six bibliographic databases were searched from inception until October 10, 2023. Meta\u2010analyses pooled the model performance using area under the curve (AUC), sensitivity, specificity, and summary receiver operating characteristic curve. Of 1544 studies screened, 8 retrospective studies were eligible, including 32 prehospital stroke scales and 21 ML models. Of the 9 prehospital scales meta\u2010analyzed, the Rapid Arterial Occlusion Evaluation had the highest pooled AUC (0.82 [95% CI, 0.79\u20130.84]). Support Vector Machine achieved the highest AUC of 9 ML models included (pooled AUC, 0.89 [95% CI, 0.88\u20130.89]). Six prehospital stroke scales and 10 ML models were eligible for summary receiver operating characteristic analysis. Pooled sensitivity and specificity for any prehospital stroke scale were 0.72 (95% CI, 0.68\u20130.75) and 0.77 (95% CI, 0.72\u20130.81), respectively; summary receiver operating characteristic curve AUC was 0.80 (95% CI, 0.76\u20130.83). Pooled sensitivity for any ML model for LVO was 0.73 (95% CI, 0.64\u20130.79), specificity was 0.85 (95% CI, 0.80\u20130.89), and summary receiver operating characteristic curve AUC was 0.87 (95% CI, 0.83\u20130.89).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Both prehospital stroke scales and ML models demonstrated varying accuracies in predicting LVO. Despite ML potential for improved LVO detection in the prehospital setting, application remains limited by the absence of prospective external validation, limited sample sizes, and lack of real\u2010world performance data in a prehospital setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.033298","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T07:07:32Z","timestamp":1718348852000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Systematic Review and Meta\u2010Analysis of Prehospital Machine Learning Scores as Screening Tools for Early Detection of Large Vessel Occlusion in Patients With Suspected Stroke"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1257-1428","authenticated-orcid":false,"given":"Muath","family":"Alobaida","sequence":"first","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]},{"name":"King Saud University","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4088-7043","authenticated-orcid":false,"given":"Martha","family":"Joddrell","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalin","family":"Zheng","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]},{"name":"Aalborg University","place":["Aalborg, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-9131","authenticated-orcid":false,"given":"Fiona J.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Institute of Population Health, University of Liverpool","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2732-5927","authenticated-orcid":false,"given":"Wahbi K.","family":"El\u2010Bouri","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2875-0546","authenticated-orcid":false,"given":"Andrew","family":"Hill","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]},{"name":"Department of Medicine, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5604-9378","authenticated-orcid":false,"given":"Deirdre A.","family":"Lane","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]},{"name":"Aalborg University","place":["Aalborg, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Harrison","sequence":"additional","affiliation":[{"name":"University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital","place":["Liverpool, UK"]},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool","place":["Liverpool, UK"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019431"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2022.2161362"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000160"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013144"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyz042"},{"issue":"53","key":"e_1_3_2_7_2","first-page":"e282","article-title":"Guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the american heart association\/american stroke association","volume":"2022","author":"Greenberg SM","year":"2022","unstructured":"Greenberg SM, Ziai WC, Cordonnier C, Dowlatshahi D, Francis B, Goldstein JN, Hemphill JC 3rd, Johnson R, Keigher KM, Mack WJ, et\u00a0al. 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