Literature DB >> 32847449

Early experience utilizing artificial intelligence shows significant reduction in transfer times and length of stay in a hub and spoke model.

Ameer E Hassan1,2,3, Victor M Ringheanu1, Rani R Rabah1, Laurie Preston1, Wondwossen G Tekle1,2,3, Adnan I Qureshi4,5.   

Abstract

BACKGROUND: Recently approved artificial intelligence (AI) software utilizes AI powered large vessel occlusion (LVO) detection technology which automatically identifies suspected LVO through CT angiogram (CTA) imaging and alerts on-call stroke teams. We performed this analysis to determine if utilization of AI software and workflow platform can reduce the transfer time (time interval between CTA at a primary stroke center (PSC) to door-in at a comprehensive stroke center (CSC)).
METHODS: We compared the transfer time for all LVO transfer patients from a single spoke PSC to our CSC prior to and after incorporating AI Software (Viz.ai LVO). Using a prospectively collected stroke database at a CSC, demographics, mRS at discharge, mortality rate at discharge, length of stay (LOS) in hospital and neurological-ICU were examined.
RESULTS: There were a total of 43 patients during the study period (median age 72.0 ± 12.54 yrs., 51.16% women). Analysis of 28 patients from the pre-AI software (median age 73.5 ± 12.28 yrs., 46.4% women), and 15 patients from the post-AI software (median age 70.0 ± 13.29 yrs., 60.00% women). Following implementation of AI software, median CTA time at PSC to door-in at CSC was significantly reduced by an average of 22.5 min. (132.5 min versus 110 min; p = 0.0470).
CONCLUSIONS: The incorporation of AI software was associated with an improvement in transfer times for LVO patients as well as a reduction in the overall hospital LOS and LOS in the neurological-ICU. More extensive studies are warranted to expand on the ability of AI technology to improve transfer times and outcomes for LVO patients.

Entities:  

Keywords:  CT angiography; Intervention; artificial intelligence; stroke

Mesh:

Year:  2020        PMID: 32847449      PMCID: PMC7645178          DOI: 10.1177/1591019920953055

Source DB:  PubMed          Journal:  Interv Neuroradiol        ISSN: 1591-0199            Impact factor:   1.610


  8 in total

1.  Association of a Primary Stroke Center Protocol for Suspected Stroke by Large-Vessel Occlusion With Efficiency of Care and Patient Outcomes.

Authors:  Ryan A McTaggart; Shadi Yaghi; Shawna M Cutting; Morgan Hemendinger; Grayson L Baird; Richard A Haas; Karen L Furie; Mahesh V Jayaraman
Journal:  JAMA Neurol       Date:  2017-07-01       Impact factor: 18.302

2.  Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke: an analysis of data from the Interventional Management of Stroke (IMS III) phase 3 trial.

Authors:  Pooja Khatri; Sharon D Yeatts; Mikael Mazighi; Joseph P Broderick; David S Liebeskind; Andrew M Demchuk; Pierre Amarenco; Janice Carrozzella; Judith Spilker; Lydia D Foster; Mayank Goyal; Michael D Hill; Yuko Y Palesch; Edward C Jauch; E Clarke Haley; Achala Vagal; Thomas A Tomsick
Journal:  Lancet Neurol       Date:  2014-04-27       Impact factor: 44.182

3.  Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials.

Authors:  Mayank Goyal; Bijoy K Menon; Wim H van Zwam; Diederik W J Dippel; Peter J Mitchell; Andrew M Demchuk; Antoni Dávalos; Charles B L M Majoie; Aad van der Lugt; Maria A de Miquel; Geoffrey A Donnan; Yvo B W E M Roos; Alain Bonafe; Reza Jahan; Hans-Christoph Diener; Lucie A van den Berg; Elad I Levy; Olvert A Berkhemer; Vitor M Pereira; Jeremy Rempel; Mònica Millán; Stephen M Davis; Daniel Roy; John Thornton; Luis San Román; Marc Ribó; Debbie Beumer; Bruce Stouch; Scott Brown; Bruce C V Campbell; Robert J van Oostenbrugge; Jeffrey L Saver; Michael D Hill; Tudor G Jovin
Journal:  Lancet       Date:  2016-02-18       Impact factor: 79.321

4.  Deconstruction of Interhospital Transfer Workflow in Large Vessel Occlusion: Real-World Data in the Thrombectomy Era.

Authors:  Felix C Ng; Essie Low; Emily Andrew; Karen Smith; Bruce C V Campbell; Peter J Hand; Douglas E Crompton; Tissa Wijeratne; Helen M Dewey; Philip M Choi
Journal:  Stroke       Date:  2017-05-16       Impact factor: 7.914

Review 5.  Statistics review 4: sample size calculations.

Authors:  Elise Whitley; Jonathan Ball
Journal:  Crit Care       Date:  2002-05-10       Impact factor: 9.097

6.  Good clinical outcome after ischemic stroke with successful revascularization is time-dependent.

Authors:  P Khatri; T Abruzzo; S D Yeatts; C Nichols; J P Broderick; T A Tomsick
Journal:  Neurology       Date:  2009-09-29       Impact factor: 9.910

7.  Analysis of Workflow and Time to Treatment and the Effects on Outcome in Endovascular Treatment of Acute Ischemic Stroke: Results from the SWIFT PRIME Randomized Controlled Trial.

Authors:  Mayank Goyal; Ashutosh P Jadhav; Alain Bonafe; Hans Diener; Vitor Mendes Pereira; Elad Levy; Blaise Baxter; Tudor Jovin; Reza Jahan; Bijoy K Menon; Jeffrey L Saver
Journal:  Radiology       Date:  2016-04-19       Impact factor: 11.105

8.  Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke).

Authors:  Michael T Froehler; Jeffrey L Saver; Osama O Zaidat; Reza Jahan; Mohammad Ali Aziz-Sultan; Richard P Klucznik; Diogo C Haussen; Frank R Hellinger; Dileep R Yavagal; Tom L Yao; David S Liebeskind; Ashutosh P Jadhav; Rishi Gupta; Ameer E Hassan; Coleman O Martin; Hormozd Bozorgchami; Ritesh Kaushal; Raul G Nogueira; Ravi H Gandhi; Eric C Peterson; Shervin R Dashti; Curtis A Given; Brijesh P Mehta; Vivek Deshmukh; Sidney Starkman; Italo Linfante; Scott H McPherson; Peter Kvamme; Thomas J Grobelny; Muhammad S Hussain; Ike Thacker; Nirav Vora; Peng Roc Chen; Stephen J Monteith; Robert D Ecker; Clemens M Schirmer; Eric Sauvageau; Alex Abou-Chebl; Colin P Derdeyn; Lucian Maidan; Aamir Badruddin; Adnan H Siddiqui; Travis M Dumont; Abdulnasser Alhajeri; M Asif Taqi; Khaled Asi; Jeffrey Carpenter; Alan Boulos; Gaurav Jindal; Ajit S Puri; Rohan Chitale; Eric M Deshaies; David H Robinson; David F Kallmes; Blaise W Baxter; Mouhammad A Jumaa; Peter Sunenshine; Aniel Majjhoo; Joey D English; Shuichi Suzuki; Richard D Fessler; Josser E Delgado Almandoz; Jerry C Martin; Nils H Mueller-Kronast
Journal:  Circulation       Date:  2017-09-24       Impact factor: 29.690

  8 in total
  13 in total

1.  Validation of a machine learning software tool for automated large vessel occlusion detection in patients with suspected acute stroke.

Authors:  Petra Cimflova; Rotem Golan; Johanna M Ospel; Alireza Sojoudi; Chris Duszynski; Ibukun Elebute; Houssam El-Hariri; Seyed Hossein Mousavi; Luis A Souto Maior Neto; Najratun Pinky; Benjamin Beland; Fouzi Bala; Nima R Kashani; William Hu; Manish Joshi; Wu Qiu; Bijoy K Menon
Journal:  Neuroradiology       Date:  2022-05-24       Impact factor: 2.804

Review 2.  Shifting machine learning for healthcare from development to deployment and from models to data.

Authors:  Angela Zhang; Lei Xing; James Zou; Joseph C Wu
Journal:  Nat Biomed Eng       Date:  2022-07-04       Impact factor: 25.671

3.  The re-invention of the vascular neuroradiologist in the age of direct-to-consumer radiology applications.

Authors:  Waleed Brinjikji
Journal:  Interv Neuroradiol       Date:  2022-01-31       Impact factor: 1.610

4.  Utilization of Artificial Intelligence-based Intracranial Hemorrhage Detection on Emergent Noncontrast CT Images in Clinical Workflow.

Authors:  Muhannad Seyam; Thomas Weikert; Alexander Sauter; Alex Brehm; Marios-Nikos Psychogios; Kristine A Blackham
Journal:  Radiol Artif Intell       Date:  2022-02-09

5.  Artificial Intelligence in "Code Stroke"-A Paradigm Shift: Do Radiologists Need to Change Their Practice?

Authors:  Achala Vagal; Luca Saba
Journal:  Radiol Artif Intell       Date:  2022-01-19

Review 6.  Artificial Intelligence for Large-Vessel Occlusion Stroke: A Systematic Review.

Authors:  Nathan A Shlobin; Ammad A Baig; Muhammad Waqas; Tatsat R Patel; Rimal H Dossani; Megan Wilson; Justin M Cappuzzo; Adnan H Siddiqui; Vincent M Tutino; Elad I Levy
Journal:  World Neurosurg       Date:  2021-12-08       Impact factor: 2.210

7.  Reply.

Authors:  A Yahav-Dovrat; G Merhav; A Eran; R Sivan-Hoffmann; M Saban; E Abergel; D Tanne; R G Nogueira
Journal:  AJNR Am J Neuroradiol       Date:  2021-05-20       Impact factor: 4.966

8.  Comparison of convolutional neural networks for detecting large vessel occlusion on computed tomography angiography.

Authors:  Lucas W Remedios; Sneha Lingam; Samuel W Remedios; Riqiang Gao; Stephen W Clark; Larry T Davis; Bennett A Landman
Journal:  Med Phys       Date:  2021-08-22       Impact factor: 4.506

9.  Studying human-AI collaboration protocols: the case of the Kasparov's law in radiological double reading.

Authors:  Federico Cabitza; Andrea Campagner; Luca Maria Sconfienza
Journal:  Health Inf Sci Syst       Date:  2021-02-05

10.  Diagnostic accuracy of automated occlusion detection in CT angiography using e-CTA.

Authors:  Fatih Seker; Johannes Alex Rolf Pfaff; Yahia Mokli; Anne Berberich; Rafael Namias; Steven Gerry; Simon Nagel; Martin Bendszus; Christian Herweh
Journal:  Int J Stroke       Date:  2021-02-11       Impact factor: 5.266

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