rosier_stroke_scale: Recognition of Stroke in the Emergency Room (ROSIER) Scale

In cliot: Clinical Indices and Outcomes Tools

Recognition of Stroke in the Emergency Room (ROSIER) Scale

Description

Calculates the ROSIER score to help emergency department staff differentiate between acute stroke and stroke mimics. The score assigns points for specific neurological deficits and subtracts points for loss of consciousness or seizure activity, which are more common in mimics.

Usage

rosier_stroke_scale(loss_of_consciousness, seizure_activity,
                    asymmetric_facial_weakness, asymmetric_arm_weakness,
                    asymmetric_leg_weakness, speech_disturbance,
                    visual_field_defect)

Arguments

loss_of_consciousness	Numeric (0 or 1). Has there been loss of consciousness or syncope? (1 = Yes, -1 point).
seizure_activity	Numeric (0 or 1). Has there been seizure activity? (1 = Yes, -1 point).
asymmetric_facial_weakness	Numeric (0 or 1). Is there new acute asymmetric facial weakness? (1 = Yes, +1 point).
asymmetric_arm_weakness	Numeric (0 or 1). Is there new acute asymmetric arm weakness? (1 = Yes, +1 point).
asymmetric_leg_weakness	Numeric (0 or 1). Is there new acute asymmetric leg weakness? (1 = Yes, +1 point).
speech_disturbance	Numeric (0 or 1). Is there speech disturbance? (1 = Yes, +1 point).
visual_field_defect	Numeric (0 or 1). Is there a visual field defect? (1 = Yes, +1 point).

Value

A list containing:

ROSIER_Score	The calculated total score (Range -2 to +5).
Likelihood	Interpretation (Stroke Likely > 0, Unlikely <= 0).
Test_Characteristics	Sensitivity and Specificity for the >0 cutoff.

References

Nor AM, Davis J, Sen B, et al. The Recognition of Stroke in the Emergency Room (ROSIER) scale: development and validation of a stroke recognition instrument. Lancet Neurol. 2005;4(11):727-734. doi:10.1016/S1474-4422(05)70201-5

Examples

# Example 1: Stroke Likely
# Face weakness (+1), Arm weakness (+1), Speech disturbance (+1)
# Score = 3
rosier_stroke_scale(0, 0, 1, 1, 0, 1, 0)

# Example 2: Stroke Unlikely (Mimic)
# Seizure (-1), LOC (-1), Arm weakness (+1)
# Score = -1
rosier_stroke_scale(1, 1, 0, 1, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.