Whiteley 2011.

Study characteristics
Patient sampling	Edinburgh Western General Hospital, UK; 21 March 2007 to 27 February 2009 Sampling: prospective consecutive people with suspected stroke, symptoms < 24 hours, symptomatic at time of assessment, GP/paramedic/member of ER staff made a diagnosis of "suspected stroke".
Patient characteristics and setting	Inclusion and exclusion criteria: symptoms began < 24 hours before admission; still symptomatic at the time of assessment; and in whom a GP, a paramedic or a member of the ER staff had made a diagnosis of 'suspected stroke' Participant characteristics: mean age 72 (SD 14) years; 51% women
Index tests	Index test: FAST, ROSIER Test administrator: emergency physician or nurse Training: not reported
Target condition and reference standard(s)	Target condition: stroke/TIA Reference standard: panel of experts (which included stroke physicians, neurologists and neuroradiologists), who had access to the clinical findings, imaging results and the participant's subsequent clinical course. Diagnostic criteria provided.
Flow and timing	50 participants excluded from analysis due to incomplete assessment.
Comparative
Diagnostic test accuracy data	Prevalence of stroke/TIA: 246/356 (69.1%) FAST: TP = 199; FP = 67; FN = 47; TN = 43 ROSIER: TP = 203; FP = 62; FN = 43; TN = 48
Notes	Categorization of alternate diagnosis for participants who did not have an ischemic stroke: TIA 37, ICH 10, SAH 2 Funding: none relevant
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Yes
Prospective design	Yes
		Low	Low
DOMAIN 2: Index Test Index tests
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	Yes
		Low	Low
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	Yes
		Low	Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Yes
Did all patients receive a reference standard?	Yes
		Low

BPPV: benign paroxysmal positional vertigo; CPSS: Cincinnati Prehospital Stroke Scale; CT: computed tomography; CTA: computed tomography angiography; ECG: electrocardiogram; EEG: electroencephalogram; EMCC: Emergency Medical Communication Center; EMS: emergency medical service; ER: emergency room; FAST: Face Arm Speech Time; FN: false negative; FP: false positive; GCS: Glasgow Coma Scale; GP: general practitioner; ICH: intracerebral hemorrhage; LAPSS: Los Angeles Prehospital Stroke Scale; LOC: level of consciousness; MASS: Melbourne Ambulance Stroke Scale; MedPACS: Medic Prehospital Assessment for Code Stroke; MPDS: medical priority dispatch system; MRA: magnetic resonance angiography; MRI: magnetic resonance imaging; NIHSS: National Institutes of Health Stroke Scale; OPSST: Ontario Prehospital Stroke Screening Tool; PreHAST: PreHospital Ambulance Stroke Test; ROSIER: Recognition of Stroke in the Emergency Room; SAH: subarachnoid hemorrhage; SBP: systolic blood pressure; SD: standard deviation; SDH: subdural hematoma; SDMSE: San Diego Medical Services Enterprise; TCD: transcranial Doppler; TGA: transient global amnesia; TIA: transient ischemic attack; TN: true negative; TP: true positive; UCLA: University of California at Los Angeles; WHO: World Health Organization.