Denver Prehospital Stroke Scale (DPSS)
The Denver Prehospital Stroke Scale (DPSS) is not mentioned or validated in current stroke guidelines or research literature. The evidence provided does not reference this scale, and it does not appear among the validated prehospital stroke screening tools recommended for clinical use.
Validated Prehospital Stroke Scales
Instead of the DPSS, current guidelines and research support the use of these validated scales:
For Basic Stroke Detection:
Cincinnati Prehospital Stroke Scale (CPSS) - The most extensively validated scale with excellent reproducibility (intraclass correlation 0.92) and sensitivity of 88% for anterior circulation strokes 1. Recent meta-analysis confirms CPSS at threshold ≥2 provides 82% sensitivity and 62% specificity for large vessel occlusion detection 2.
Face-Arm-Speech-Time (FAST) - Comparable accuracy to CPSS in emergency department settings 3
Recognition of Stroke in the Emergency Room (ROSIER) - Pooled sensitivity of 88% (95% CI 0.84-0.91) when used in emergency departments, though specificity varies widely 3
For Large Vessel Occlusion Detection:
Guidelines recommend using validated stroke severity assessment tools to identify patients who may benefit from endovascular thrombectomy 4, 5:
Rapid Arterial oCclusion Evaluation (RACE) - Highest accuracy (AUC 0.83) for detecting anterior large vessel occlusions in prospective field validation 6
Gaze-Face-Arm-Speech-Time (G-FAST) and CG-FAST - Both demonstrated AUC of 0.80 for large vessel occlusion detection 6
Los Angeles Prehospital Stroke Scale (LAPSS) - Summary sensitivity 0.83 and specificity 0.93, though methodologic concerns exist 3
Clinical Implications
If you encountered reference to a "Denver Prehospital Stroke Scale," it may be a local adaptation or misidentification of an established scale. For prehospital stroke screening, use CPSS for basic stroke detection 4, 1 and consider RACE, G-FAST, or CG-FAST for identifying potential large vessel occlusions requiring direct transport to thrombectomy-capable centers 6.
The 2021 AHA/ASA consensus statement explicitly recommends that "a standard prehospital stroke severity assessment tool should be used to facilitate triage" but does not endorse any scale called the Denver Prehospital Stroke Scale 4.