What question did this study set out to answer?

To prospectively determine whether video-based telemedicine is superior to telephone-only consultations for acute stroke thrombolysis decision-making.

March 8, 2012Telemedicine Journal and e-Health

Efficacy of Telemedicine for Stroke: Pooled Analysis of the Stroke Team Remote Evaluation Using a Digital Observation Camera (STRokE DOC) and STRokE DOC Arizona Telestroke Trials

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Authors

BDBart M. DemaerschalkMayo Clinic RRRema RamanRutgers, The State University of New Jersey KEKarin ErnströmSouthern States University

Discussion

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Implication

Pooled analysis of randomized trials shows telemedicine improves thrombolysis decision accuracy in acute stroke, indicating its value for remote emergency consultations.

Key Points

To prospectively determine whether video-based telemedicine is superior to telephone-only consultations for acute stroke thrombolysis decision-making.
Pooled individual patient data from two identically designed randomized controlled trials (STRokE DOC and STRokE DOC Arizona) conducted across a multistate hub-and-spoke telestroke network.
Evaluated N=276 patients presenting with acute stroke syndrome who were randomized to receive either telemedicine or telephone-only consultations.
Assessed primary endpoint of correct thrombolysis decision-making alongside secondary outcomes, including rt-PA use, 90-day functional recovery, and symptomatic intracranial hemorrhage.
Correct thrombolysis eligibility decisions occurred significantly more often with telemedicine than telephone-only consultations (96% vs 83%; OR 4.2; 95% CI 1.69–10.46; p=0.002).
Intravenous rt-PA was administered in 29% of telemedicine consultations compared to 24% of telephone consultations (OR 1.27; 95% CI 0.71–2.25; p=0.41).
Rates of post-thrombolysis intracranial hemorrhage (8% telemedicine vs 6% telephone; p>0.999) and 90-day functional outcomes (Barthel Index, modified Rankin Scale, and mortality) did not differ significantly between groups.

Cite This Study

Demaerschalk et al. (2012) studied this question.

synapsesocial.com/papers/6a70eb1afe4101aa97e05e8a https://doi.org/10.1089/tmj.2011.0116

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Implication

Pooled analysis of randomized trials shows telemedicine improves thrombolysis decision accuracy in acute stroke, indicating its value for remote emergency consultations.

Efficacy of Telemedicine for Stroke: Pooled Analysis of the Stroke Team Remote Evaluation Using a Digital Observation Camera (STRokE DOC) and STRokE DOC Arizona Telestroke Trials

Discussion

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Implication

Key Points

Cite This Study

Efficacy of Telemedicine for Stroke: Pooled Analysis of the Stroke Team Remote Evaluation Using a Digital Observation Camera (STRokE DOC) and STRokE DOC Arizona Telestroke Trials

Discussion

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Implication

Key Points

Cite This Study

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