A new Australian study has found that improving how strokes are detected in women before they reach hospital could not only save lives but cut healthcare costs by millions each year.
Published in the Medical Journal of Australia, the research reveals that women are 11 per cent less likely than men to be correctly identified as having a stroke by emergency medical staff. The difference is costing women days of life, years of health, and in some cases, their chance at early treatment.
Led by Associate Professor Lei Si from Western Sydney University, the study used health economic modelling to show how lifting stroke detection rates in women to match those in men would bring gains in both quality-adjusted life years and health system savings.
“Our study shows that if we could match the accuracy with which men’s strokes are identified, women would gain an average of 51 extra days of life and nearly a month of life in perfect health—all while saving nearly $3,000 in healthcare costs per patient,” said Associate Professor Si.
“At the national level, this could translate to over 250 additional life years, 144 extra quality-adjusted life years, and $5.4 million in healthcare savings each year.”
The urgency of accurate stroke detection is well known. Receiving treatment such as intravenous thrombolysis (IVT) within the first 60 minutes can dramatically improve outcomes. But existing tools like the widely used F.A.S.T. acronym—which stands for Face, Arms, Speech and Time—don’t cover the full range of symptoms, especially those more commonly seen in women.
Jordan Springs resident Kelly Ryan knows that gap too well. She was 32 when she had a stroke in the posterior part of her brain following a chiropractic session. At the time, her symptoms were severe: loss of balance, double vision, vomiting and a piercing headache. Yet she wasn’t diagnosed immediately.
“Initially I shrugged off as just having a migraine and vertigo as I was not FAST positive,” she said. “It took six hours to get a CT scan, and I was sent home with an outpatient appointment for an MRI a week later. It took a total of 2 weeks to be diagnosed as having a stroke.”
The delayed diagnosis meant she missed the window for early intervention.
“Had my stroke been recognised early on, I may have been a candidate for the clot busting drug which could have stopped or at least reduced the damage of the stroke,” she said.
Her case isn’t isolated.
“People all around the world have been through the same thing, sometimes even waiting months for someone to take them seriously as medical staff are so focused on someone being FAST positive to diagnose stroke, people like me are falling through the cracks,” she said.
While F.A.S.T. has been a helpful tool for many, the study suggests it is time for a broader approach that reflects how stroke symptoms present differently across genders.
The research, titled Health and economic benefits of improving pre-hospital identification of stroke in Australian women: a modelling study, was conducted by a team from Western Sydney University, UNSW Sydney, and The George Institute for Global Health in Australia and the UK.
As Australia’s healthcare system continues to grapple with cost pressures and workforce demands, targeted improvements in stroke detection could offer a rare win–win: better outcomes for patients and lower costs for the public purse. The findings also raise fresh questions about how medical protocols are tested and taught, and whether tools like F.A.S.T. are due for a rethink.
Improving accuracy in stroke recognition isn’t a matter of technology or expense. As the study suggests, it’s about adjusting how emergency staff are trained to recognise symptoms—especially the ones that fall outside the textbook.
And when lives and millions are at stake, there’s little excuse not to act.
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