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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 6 of 6 Research Studies Displayed
Swanson MB, Miller AC, Ward MM MM
Emergency department telemedicine consults decrease time to interpret computed tomography of the head in a multi-network cohort.
Telemedicine can improve access to emergency stroke care in rural areas, but the benefit of telemedicine across different types and models of telemedicine networks is unknown. The objectives of this study were to (1) identify the impact of telemedicine on ED stroke care, (2) identify if telemedicine impact varied by network, and (3) describe the variation in process outcomes by telemedicine across EDs.
Citation: Swanson MB, Miller AC, Ward MM MM . Emergency department telemedicine consults decrease time to interpret computed tomography of the head in a multi-network cohort. J Telemed Telecare 2021 Jul;27(6):343-52. doi: 10.1177/1357633x19877746..
Keywords: Emergency Department, Telehealth, Health Information Technology (HIT), Imaging, Stroke, Cardiovascular Conditions
Saber Tehrani AS, Kattah JC, Kerber KA
Diagnosing stroke in acute dizziness and vertigo: pitfalls and pearls.
Diagnosing cerebrovascular causes of acute dizziness and vertigo is both important and difficult. It is not routinely done well in current clinical ED practice. Current best evidence suggests an approach emphasizing dizziness timing and triggers, focused ocular motor examinations, and MRI, as needed. Alternative strategies to disseminate this approach may be required.
Citation: Saber Tehrani AS, Kattah JC, Kerber KA . Diagnosing stroke in acute dizziness and vertigo: pitfalls and pearls. Stroke 2018 Mar;49(3):788-95. doi: 10.1161/strokeaha.117.016979.
Keywords: Diagnostic Safety and Quality, Imaging, Stroke
Yaghi S, Herber C, Willey JZ
Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits.
The researchers' aim was to identify predictors of MRI-positive stroke from the itemized NIHSS. They concluded that NIHSS score subsets predict diffusion-weighted imaging positivity in mild strokes, and the presence of neglect or visual field deficits on the NIHSS subsets is most likely to have an MRI correlate even in patients with low NIHSS.
Citation: Yaghi S, Herber C, Willey JZ . Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits. J Neurol Sci 2015 Nov 15;358(1-2):221-5. doi: 10.1016/j.jns.2015.08.1548.
Keywords: Diagnostic Safety and Quality, Imaging, Stroke
Schaefer PW, Souza L, Kamalian S
Limited reliability of computed tomographic perfusion acute infarct volume measurements compared with diffusion-weighted imaging in anterior circulation stroke.
The researchers tested whether thresholded computed tomographic cerebral blood flow (CT-CBF) and CT-cerebral blood volume (CT-CBV) maps are sufficiently accurate to substitute for diffusion-weighted imaging (DWI) for estimating the critically ischemic tissue volume. They found that the poor contrast:noise ratios of CT-CBV and CT-CBF compared with those of DWI result in large measurement error, make it problematic to substitute CTP for DWI in selecting individual acute stroke patients for treatment.
Citation: Schaefer PW, Souza L, Kamalian S . Limited reliability of computed tomographic perfusion acute infarct volume measurements compared with diffusion-weighted imaging in anterior circulation stroke. Stroke 2015 Feb;46(2):419-24. doi: 10.1161/strokeaha.114.007117..
Keywords: Stroke, Imaging
George AJ, Boehme AK, Dunn CR
Trimming the fat in acute ischemic stroke: an assessment of 24-h CT scans in tPA patients.
The authors questioned the utility of routine 24-h computed tomography imaging and looked at the National Institutes of Health Stroke Scale as a possible clinical screen for selecting candidates for 24-h imaging. They found that routine 24-h computed tomography scan in patients without 24-h National Institutes of Health Stroke Scale worsening was less likely to yield information that results in a deviation from standard acute stroke care, and that no patient without worsening had parenchymal hematoma on 24-h computed tomography. They concluded that application of this Stroke Scale to distinguish patients who should have 24-h follow-up imaging from those who will not benefit is a potential avenue for improving utilization of resources and warrants further study.
Citation: George AJ, Boehme AK, Dunn CR . Trimming the fat in acute ischemic stroke: an assessment of 24-h CT scans in tPA patients. Int J Stroke 2015 Jan;10(1):37-41. doi: 10.1111/ijs.12293.
Keywords: Decision Making, Imaging, Stroke, Value
Lyerly MJ, Houston JT, Boehme AK
Safety of intravenous tissue plasminogen activator administration with computed tomography evidence of prior infarction.
The researchers sought to determine if the presence of a previous stroke on pretreatment computed tomography (CT) is a predictor of hemorrhagic complications and functional outcomes after the administration of intravenous (IV) tissue plasminogen activator (tPA). Their data suggest that a prior stroke on CT should not be viewed as a reason to withhold this treatment unless it occurred within the last 3 months.
Citation: Lyerly MJ, Houston JT, Boehme AK . Safety of intravenous tissue plasminogen activator administration with computed tomography evidence of prior infarction. J Stroke Cerebrovasc Dis 2014 Jul;23(6):1657-61. doi: 10.1016/j.jstrokecerebrovasdis.2014.01.011..
Keywords: Stroke, Risk, Outcomes, Imaging