🧠 ROSIER Scale (Stroke Recognition)
Differentiate stroke from mimics in the emergency department with the ROSIER scale.
Clinical takeaway
Score > 0 — stroke is likely; activate the pathway.
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When to use
Rapidly recognise acute stroke at first contact.
How it works
Add face/arm/leg weakness, speech disturbance, visual field defect (+1 each); subtract for loss of consciousness/syncope and seizure (−1 each). Score > 0 makes stroke likely.
Key points
- Score > 0 — stroke is likely; activate the pathway.
- ≤ 0 does not fully exclude stroke — clinical judgement applies.
- Designed for ED use by non-specialists.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Loss of consciousness/syncope | No |
|---|---|
| Seizure activity | No |
| Asymmetric facial weakness | No |
| Asymmetric arm weakness | No |
| Asymmetric leg weakness | No |
| Speech disturbance | No |
| Visual field defect | No |
→ROSIER0
- Interpretation：Score ≤ 0 — stroke less likely (does not exclude); reassess.
| Loss of consciousness/syncope | Yes (−1) |
|---|---|
| Seizure activity | Yes (−1) |
| Asymmetric facial weakness | Yes (+1) |
| Asymmetric arm weakness | Yes (+1) |
| Asymmetric leg weakness | Yes (+1) |
| Speech disturbance | Yes (+1) |
| Visual field defect | Yes (+1) |
→ROSIER+3
- Interpretation：Score > 0 — stroke likely; activate stroke pathway.
Frequently asked questions
- What is ROSIER Scale (Stroke Recognition)?
- Differentiate stroke from mimics in the emergency department with the ROSIER scale.
- How is ROSIER Scale (Stroke Recognition) calculated? What is the core formula?
- Add face/arm/leg weakness, speech disturbance, visual field defect (+1 each); subtract for loss of consciousness/syncope and seizure (−1 each). Score > 0 makes stroke likely.
- When is ROSIER Scale (Stroke Recognition) used?
- Rapidly recognise acute stroke at first contact.
- What are the key clinical points for ROSIER Scale (Stroke Recognition)?
- Score > 0 — stroke is likely; activate the pathway. ≤ 0 does not fully exclude stroke — clinical judgement applies. Designed for ED use by non-specialists.
- What are the limits and cautions when using ROSIER Scale (Stroke Recognition)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is ROSIER Scale (Stroke Recognition) calculated in practice? Can you show a worked example?
- Inputs: Loss of consciousness/syncope No, Seizure activity No, Asymmetric facial weakness No, Asymmetric arm weakness No, Asymmetric leg weakness No, Speech disturbance No, Visual field defect No → Result: ROSIER 0（Interpretation: Score ≤ 0 — stroke less likely (does not exclude); reassess.） Inputs: Loss of consciousness/syncope Yes (−1), Seizure activity Yes (−1), Asymmetric facial weakness Yes (+1), Asymmetric arm weakness Yes (+1), Asymmetric leg weakness Yes (+1), Speech disturbance Yes (+1), Visual field defect Yes (+1) → Result: ROSIER +3（Interpretation: Score > 0 — stroke likely; activate stroke pathway.）