FAST Beats BE-FAST: Which Acronym Works Better for Public Stroke Recognition?
The widely recognized FAST acronym continues to be the best tool for helping bystanders identify stroke symptoms. Recent research indicates that expanding FAST to BE-FAST, which includes Balance and Eye changes, does not significantly improve the public’s quick response to suspected strokes.
Study Reveals FAST’s Superiority
A study presented at the International Stroke Conference (ISC) 2025 showed that FAST (Face drooping, Arm weakness, Speech difficulty, Time to call 911) performed better than BE-FAST in terms of recalling key symptoms.
Dr. Opeolu Adeoye, a professor from Washington University School of Medicine and a volunteer with the American Heart/Stroke Association, commented, “Our desire to capture everything may actually overwhelm the general public. In this case, I would suggest that perfect is the enemy of good.”
Why FAST Remains Effective
Despite FAST capturing only about 80% of strokes, it has been used for over 20 years and is well-known to the public. Neurologists introduced BE-FAST to identify strokes in the back of the brain, which FAST often misses.
The study involved 1,900 English-speaking US residents who watched either a FAST or BE-FAST video. Immediately after watching, the likelihood of calling 911 increased for both groups, with 72% to 90% for FAST and 71% to 90% for BE-FAST.
Key Findings of the Study
The ability to recall key symptoms of F, A, and S was significantly higher in the FAST group compared to BE-FAST. After 30 days, while both groups saw a decline in recall, FAST still had a higher recognition rate at 50% versus BE-FAST’s 40%.
Dr. Adeoye explained, “For awareness of stroke signs and symptoms, that’s where I think BE-FAST loses ground relative to FAST.”
Expert Opinion
Dr. William “B.J.” Hicks, vice president of Neurosciences at Ohio Health, echoed these findings. He stated, “The study provides useful information for stroke neurologists. FAST doesn’t encapsulate all possible stroke symptoms, but it’s easily and readily identifiable by all Americans.”
Hicks added, “Adding the two extra letters might interfere with providing a clear message. Sometimes you pile on a little bit too much and it just becomes noise.”
Future Considerations
While FAST is more effective for public education, Dr. Adeoye noted that BE-FAST may still be useful for healthcare professionals. However, the study did not specifically assess that outcome.
Experts believe that the simplicity and memorability of FAST are its key strengths. This study reinforces the effectiveness of keeping stroke education straightforward for the general public.
Conclusion
Research continues to shape how we approach public health education. In the case of stroke recognition, FAST appears to be the most effective tool for quick identification and response. Simplifying messages can be more impactful than adding complexity.
With stroke being a time-sensitive emergency, ensuring that the public can recognize symptoms rapidly is crucial. FAST remains the acronym that achieves this goal the most effectively.
We invite you to share your thoughts below. Do you find FAST easier to remember and use? Let us know your perspective!
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