Validation of a cloud-based tele-stroke system reliability in determining national institutes of health stroke scale scores for acute ischemic stroke screening in the emergency department

被引:1
作者
Saban, Mor [1 ]
Moskovitz, Anner [2 ]
Ohanyan, Sona [3 ]
Reznik, Anna [3 ]
Ribo, Marc [4 ]
Sivan-Hoffmann, Rotem [5 ]
机构
[1] Gertner Inst Hlth Policy & Epidemiol, Ramat Gan, Israel
[2] Technion Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Haifa, Israel
[3] Rambam Healthcare Campus, Dept Neurol, Haifa, Israel
[4] Vall dHebron Univ Hosp, Dept Intervent Neuroradiol, Barcelona, Spain
[5] Rambam Healthcare Campus, Dept Intervent Neuroradiol, Haifa, Israel
关键词
stroke; National Institute of Health Stroke Scale; large vessel occlusion; tele-stroke; remote diagnosis; LARGE VESSEL OCCLUSION; ENDOVASCULAR THROMBECTOMY; SMARTPHONE APPLICATION; EARLY MANAGEMENT; 2018; GUIDELINES; TELEMEDICINE; REMOTE; OUTCOMES; TIME;
D O I
10.3389/fneur.2022.973165
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and purposeThe National Institutes of Health Stroke Scale (NIHSS) is the most recommended tool for objectively quantifying the impairment caused by a suspected stroke. Nevertheless, it is mainly used by trained neurologists in the emergency department (ED). To bring forward the NIHSS to the pre-hospital setting, a smartphone-based Telestroke system was developed. It captures the full NIHSS by video, transmits it off-line, and enables assessment by a distant stroke physician. We aimed to compare the reliability of an NIHSS score determined by a neurologist from afar, using the platform with a standard NIHSS assessment performed in the emergency departments. MethodsA multi-center prospective study was conducted in two centers (Vall d'Hebron, Barcelona, and Rambam, Israel). Patients admitted to the ED with suspected stroke had a neurological exam based on the NIHSS, while being recorded by the system. A skilled neurologist rated the NIHSS according to the videos offline. The results were compared with the NIHSS score given by a neurologist at the bedside. ResultsA total of 95 patients with suspected stroke were included. The overall intraclass correlation coefficient was 0.936 (0.99 in VdH and 0.84 in Rambam), indicating excellent and good reliability, respectively. ConclusionRemote stroke assessment based on the NIHSS, using videos segments collected by a dedicated platform, installed on a standard smartphone, is a reliable measurement as compared with the bedside evaluation.
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页数:6
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