A new study set to be presented at the American Stroke Association’s International Stroke Conference 2025 has found that both F.A.S.T. (Face, Arm, Speech, Time) and BE-FAST (Balance, Eyes, Face, Arm, Speech, Time) are equally effective in prompting people to call 911 at the first sign of a stroke. However, participants were better at recalling key stroke warning signs—face drooping, arm weakness, and speech difficulty—when using the simpler F.A.S.T. acronym.
With 800,000 strokes occurring in the U.S. each year, quick recognition of symptoms and immediate medical intervention can make the difference between survival and long-term disability. This study helps determine which public awareness strategy may be most effective in ensuring stroke victims get help as quickly as possible.
Why the Acronym Matters in Stroke Response
When someone is experiencing a stroke, every minute counts. The faster they receive treatment, the greater their chances of recovery. Both F.A.S.T. and BE-FAST are designed to help people quickly identify stroke symptoms and take action by calling 911.
While the American Stroke Association currently promotes F.A.S.T., some healthcare organizations have adopted BE-FAST, believing that adding Balance (B) and Eye (E) symptoms could help identify posterior circulation strokes, which affect about 20% of stroke patients and can be more disabling.
To compare the two acronyms, researchers conducted a nationwide online survey with 1,900 participants, who were randomly assigned to one of the two acronym groups and shown a one-minute educational video. Stroke symptom knowledge and intent to call 911 were assessed immediately after the video and again 30 days later.
F.A.S.T. Was Easier to Remember: Stroke Warning
- Both acronyms increased the likelihood of calling 911 from 70% (baseline) to 90% immediately after the video. However, at the 30-day mark, this number slightly declined (86% for F.A.S.T., 87% for BE-FAST), though still significantly higher than at baseline.
- Participants in the F.A.S.T. group were significantly better at recalling the core stroke symptoms (Face, Arm, and Speech) than those in the BE-FAST group.
- At baseline, only 34% of F.A.S.T. participants and 29% of BE-FAST participants could identify what the letters F, A, and S stood for.
- Immediately after watching the video, recall jumped to 70% for F.A.S.T. vs. 50% for BE-FAST.
- After 30 days, recall declined but remained significantly higher than at baseline (50% for F.A.S.T. vs. 40% for BE-FAST).
Simplicity May Be Key in Public Health Messaging
The study suggests that adding extra letters may make it harder for people to remember stroke symptoms, potentially delaying recognition and treatment.
“Historically, healthcare professionals want to provide the most comprehensive warning sign mnemonic to ensure no strokes are missed,” said study lead author Dr. Opeolu Adeoye, chair of emergency medicine at Washington University School of Medicine. “What this research shows is, from a public point of view, adding two extra letters made it more challenging to recall the stroke warning signs.”
The findings highlight a critical trade-off: While BE-FAST may help identify more strokes, particularly in the posterior circulation, the increased complexity may reduce public recall of the most common and recognizable symptoms.
The Next Steps in Stroke Awareness and Stroke Warning
With stroke remaining a leading cause of disability and death, ensuring that as many people as possible recognize the warning signs is essential. The study’s findings could influence future public health campaigns and medical guidelines on which acronym to use for stroke education.
“The more people are aware of the stroke warning signs, the better we may activate the processes needed to ensure patients get care as quickly as possible,” Adeoye said.
For now, F.A.S.T. appears to have an edge in public recall, making it a strong choice for maximizing awareness and encouraging life-saving action when every second matters.
Reference: American Heart Association. “Stroke warning sign acronyms drive 911 calls, F.A.S.T. leads in symptom recall for public.” ScienceDaily. ScienceDaily, 30 January 2025. <www.sciencedaily.com/releases/2025/01/250130161707.htm>.
