Advancing Telestroke Care: A Prospective Observational Study

Study Overview
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Brief Summary
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This study will promote the development and economic sustainability of telemedicine for acute stroke treatment.

Detailed Description
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The goal of this study is to promote the development and economic sustainability of telemedicine for acute stroke treatment. The study's objectives are 1) to determine if the use of telemedicine consultations for stroke patients will improve their care per guidelines compared to stroke patients treated by control hospitals; and 2) to determine if the care per guidelines provided via telemedicine consultations for stroke patients will be similar or equivalent to care per guidelines provided to stroke patients treated at hub hospitals. The Advancing Telestroke Care study will establish treatment and outcomes in three distinct study cohorts: hub telemedicine hospital, spoke telemedicine hospital and non-telemedicine control hospital.

Official Title
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Advancing Telestroke Care: A Prospective Observational Study

Conditions
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Stroke

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age greater than or equal to 18 years old Acute ischemic stroke within 12 hours of stroke onset Exclusion Criteria: Life expectancy less than 90 days Patient unwilling to participate in study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Hub Hospital<br>Hub Hospital Cohort: Joint Commission-certified Primary Stroke Centers where patients are treated using hospital-based stroke teams and pathways; these hospital personnel also provide telemedicine consultation to satellite hospitals. | |
| Spoke Hospital<br>Spoke Hospital Cohort: non-stroke center certified sites, where patients are treated at an in-network telestroke community hospital using telemedicine technology with consultation provided by physicians from a hub hospital. | |
| Control Hospital<br>Control Hospital Cohort: non-stroke center certified sites with no telemedicine services. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| IV tPA administration | Correctness of decisions regarding IV tPA administration in acute stroke | Day 7/Discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Multiple Study Assessments | There are 23 assessments, after stroke, for outcome measures. They include: hospital transfers, treatment with reperfusions therapies, treatment with antiplatelets, hypertension treatment, hyperglycemia treatment, hyperlipidemia treatment, symptomatic ICH, mortality, imaging/diagnostic data, stroke and rehab scale scores, number of hospitalizations since last assessment, hospital LOS, discharge location, number of physician visits, and work status. | Day 7 and/or Day 30 and/or Day 90 and/or at discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, Telemedicine, Telestroke