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Validation of a screening questionnaire for stroke detection in Spanish-speaking communities

Abstract:

Objective. To evaluate the accuracy of an screening questionnaire for stroke detection in speaking-speaking communities. Patients and methods. We performed a door-to-door survey in Atahualpa (a rural community in coastal Ecuador) using a modified version of the Spanish translation of the WHO questionnaire for stroke detection. Subjects suspected of having a stroke as well as a 2% sample of negative subjects were evaluated by neurologists to evaluate sensitivity, specificity, and pbkp_redictive value of the questionnaire and that of each of its questions. Results. We found 18 possible cases among 1,568 individuals ≥ 15 years old. Of these, 10 were confirmed stroke patients and 8 were false-positive (crude stroke prevalence of 6.38 per 1,000). We did not find false-negative cases. Sensitivity of the questionnaire was 100%, specificity was 99.5%, positive pbkp_redictive value was 0.55 and negative pbkp_redictive value was 1. The accuracy of each question as well as the number of questions answered as affirmative were different between patients and false-positive cases. Conclusions. The current questionnaire is highly sensitive but its positive pbkp_redictive value is poor. This causes problems in large-scale studies, as the detection of many false-positives may compromise its viability. We propose a modification of the questionnaire that will turn it more accurate.