Dominique A Cadilhac1,2, Kathleen L Bagot1,2, Bart M Demaerschalk3, Gordian Hubert4, Lee Schwamm5, Caroline L Watkins6, Catherine Elizabeth Lightbody6, Joosup Kim1,2, Michelle Vu7, Nancy Pompeani1, Jeffrey Switzer8, Juanita Caudill8, Juan Estrada5, Anand Viswanathan5, Nikolai Hubert4, Robin Ohannessian9,10, David Hargroves11, Nicholas Roberts12, Timothy Ingall13, David C Hess8, Annemarei Ranta14, Vasantha Padma15, Christopher F Bladin1,16,17. 1. Public Health Group, Stroke Division, Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Australia. 2. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia. 3. Department of Neurology and Center for Connected Care, Mayo Clinic College of Medicine and Science, USA. 4. TEMPiS Telemedical Stroke Center, Department of Neurology, München Klinik Harlaching, Germany. 5. Partners Telestroke Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, USA. 6. Faculty of Health and Wellbeing, University of Central Lancashire, UK. 7. Clinical Services, Epworth HealthCare, Richmond, Australia. 8. Department of Neurology, Medical College of Georgia at Augusta University, USA. 9. Laboratoire de Neurosciences Intégratives et Cliniques, Université de Franche-Comté, France. 10. Télémédecine 360, TLM360, Paris, France. 11. East Kent Hospital University NHS Foundation Trust, UK. 12. Department of Medicine for Older People, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, UK. 13. Department of Neurology, Mayo Clinic College of Medicine and Science, USA. 14. Department of Medicine, University of Otago Wellington, New Zealand. 15. Department of Neurology, AIIMS, India. 16. Ambulance Victoria, Melbourne, Australia. 17. Eastern Health Clinical School, Melbourne, Australia.
Abstract
INTRODUCTION: Globally, the use of telestroke programmes for acute care is expanding. Currently, a standardised set of variables for enabling reliable international comparisons of telestroke programmes does not exist. The aim of the study was to establish a consensus-based, minimum dataset for acute telestroke to enable the reliable comparison of programmes, clinical management and patient outcomes. METHODS: An initial scoping review of variables was conducted, supplemented by reaching out to colleagues leading some of these programmes in different countries. An international expert panel of clinicians, researchers and managers (n = 20) from the Australasia Pacific region, USA, UK and Europe was convened. A modified-Delphi technique was used to achieve consensus via online questionnaires, teleconferences and email. RESULTS: Overall, 533 variables were initially identified and harmonised into 159 variables for the expert panel to review. The final dataset included 110 variables covering three themes (service configuration, consultations, patient information) and 12 categories: (1) details about telestroke network/programme (n = 12), (2) details about initiating hospital (n = 10), (3) telestroke consultation (n = 17), (4) patient characteristics (n = 7), (5) presentation to hospital (n = 5), (6) general clinical care within first 24 hours (n = 10), (7) thrombolysis treatment (n = 10), (8) endovascular treatment (n = 13), (9) neurosurgery treatment (n = 8), (10) processes of care beyond 24 hours (n = 7), (11) discharge information (n = 5), (12) post-discharge and follow-up data (n = 6). DISCUSSION: The acute telestroke minimum dataset provides a recommended set of variables to systematically evaluate acute telestroke programmes in different countries. Adoption is recommended for new and existing services.
INTRODUCTION: Globally, the use of telestroke programmes for acute care is expanding. Currently, a standardised set of variables for enabling reliable international comparisons of telestroke programmes does not exist. The aim of the study was to establish a consensus-based, minimum dataset for acute telestroke to enable the reliable comparison of programmes, clinical management and patient outcomes. METHODS: An initial scoping review of variables was conducted, supplemented by reaching out to colleagues leading some of these programmes in different countries. An international expert panel of clinicians, researchers and managers (n = 20) from the Australasia Pacific region, USA, UK and Europe was convened. A modified-Delphi technique was used to achieve consensus via online questionnaires, teleconferences and email. RESULTS: Overall, 533 variables were initially identified and harmonised into 159 variables for the expert panel to review. The final dataset included 110 variables covering three themes (service configuration, consultations, patient information) and 12 categories: (1) details about telestroke network/programme (n = 12), (2) details about initiating hospital (n = 10), (3) telestroke consultation (n = 17), (4) patient characteristics (n = 7), (5) presentation to hospital (n = 5), (6) general clinical care within first 24 hours (n = 10), (7) thrombolysis treatment (n = 10), (8) endovascular treatment (n = 13), (9) neurosurgery treatment (n = 8), (10) processes of care beyond 24 hours (n = 7), (11) discharge information (n = 5), (12) post-discharge and follow-up data (n = 6). DISCUSSION: The acute telestroke minimum dataset provides a recommended set of variables to systematically evaluate acute telestroke programmes in different countries. Adoption is recommended for new and existing services.
Entities:
Keywords:
Stroke; clinical care processes; minimum data set; patient outcomes; telemedicine; telestroke
Authors: Bart M Demaerschalk; Maria I Aguilar; Timothy J Ingall; David W Dodick; Bert B Vargas; Dwight D Channer; Erica L Boyd; Terri E J Kiernan; Dennis G Fitz-Patrick; J Gregory Collins; Joseph G Hentz; Brie N Noble; Qing Wu; Karina Brazdys; Bentley J Bobrow Journal: Telemed Rep Date: 2022-03-14