In our previous study, we have developed the Child Psychosis-risk Screening System (CPSS), which incorporates psychological and behavioral characteristics of childhood into an algorithm, based on a retrospective survey.

In this study, we actually tried to evaluate the risk of psychosis in pediatric and psychiatric outpatients using the CPSS.

We conducted an epidemiological study of 323 outpatients aged 6-18 years visiting pediatric and psychiatric departments using CBCL and clinical data (sex, age, winter birth, chief complaint, diagnosis, abuse, bullying, hikikomori). ROC analysis was used to assess the accuracy of CPSS predictions. Cross-sectional logistic regression analysis was performed on the clinical data to identify factors associated with risk groups exceeding the cutoff value.

The results of the ROC analysis showed that the AUC (Area under the ROC Curve) was 80.3%, indicating that the CPSS has Moderate accuracy. The cutoff value was 98.11% (sensitivity: 0.857, specificity: 0.835), and 18% of the subjects were identified as risk groups above this value. Cross-sectional logistic regression analysis showed that schizophrenia diagnosis, no abuse, winter birth, and hikikomori were associated with the risk group, with respective odds ratios of 22.88, 10.76, 1.91, and 1.37.

The results of this study suggest that the CPSS can be applied to pediatric practice for early detection of risk for psychosis. The risk group is also present among pediatric patients with physical chief complaints. The factors suggested to be associated with risk groups may reflect the factors acting on the critical period of psychosis onset and the dynamic state.

No significant relationships.

Prehospital identification of large vessel occlusion (LVO) stroke may expedite treatment by direct transport to comprehensive stroke centers (CSCs) with endovascular capabilities. The Cincinnati Prehospital Stroke Scale (CPSS) is commonly used for prehospital stroke detection. We aimed to assess whether (1) a high CPSS score can identify LVO and (2) an Emergency Medical Service (EMS) redirection protocol based on high CPSS accelerated endovascular treatment (EVT).

A retrospective comparison of patients transported by EMSs for suspected stroke to a high-volume CSC over a 16-month period, before and after implementation of an EMS redirection protocol based on high CPSS score (3/3). Charts were reviewed to determine the presence of LVO. Time to EVT and 3-month outcomes were compared before and after implementation.

A prehospital CPSS 3/3 score was found in 223 (59%) patients, demonstrating positive and negative predictive values for LVO of 29% and 94%, respectively. CPSS-based EMS redirection increased the proportion of EVT performed after direct transport to CSC [before: 21 (36%), after: 45 (63%), p < 0.01] and decreased median first door-to-groin puncture time by 28 minutes [109 (interquartile range (IQR) 64–116) versus 81 (IQR 56–130), p = 0.03]. At 3 months, the proportion of patients achieving functional independence (modified Rankin score 0–2) went from 20/57 (35%) to 29/68 (43%) (p = 0.39) following implementation.

CPSS-based EMS redirection accelerated identification of LVO strokes in the out-of-hospital setting and decreased time to EVT. Nevertheless, this protocol was also associated with high rates of non-LVO stroke. Impact on clinical outcomes should be evaluated in a larger cohort.