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A number of new studies have introduced a different risk score in contrast to National Institute of Health Stroke Scale (NIHSS) to predict prognosis in ischemic stroke (1, 2). Other recent studies have evaluated NIHSS and compared traditionally established risk scores, with newly modified models (3–8). New modeling can ease the access of scaling systems, develop a better educational background, and reveal the main common basis of the more complex models. Though the idea is clever, we’d like to highlight three educational concerns regarding the handling of the future studies on NIHSS, stroke scaling, and relative comparisons.

Comparing the Predictive Ability of Prognostic Models in Ischemic Stroke; Derivation, Validation, and Discrimination Beyond the ROC Curve