Standardized Reporting of Workflow Metrics in Acute Ischemic Stroke Treatment: Why and How?

Author:

Goyal Mayank12ORCID,Saver Jeffrey L.3,Ganesh Aravind12,McDonough Rosalie V.12,Roos Yvo B.W.E.M.4,Boulouis Grégoire5,Kurz Martin6,Psychogios Marios‐Nikos7,Holmin Staffan8,Majoie Charles B.L.M.9,Bourcier Romain10,Chandra Ronil11,Yoshimura Shinichi12,Yavagal Dileep13,Gory Benjamin14,Taschner Christian15,Buck Brian16,Jadhav Ashutosh17,Hill Michael D.12,Ospel Johanna Maria127

Affiliation:

1. Department of Clinical Neurosciences University of Calgary Calgary Canada

2. Department of Diagnostic Imaging University of Calgary Calgary Canada

3. Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine University of California Los Angeles CA

4. Department of Neurology, Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands

5. Department of Neuroradiology Tours University Hospital Tours France

6. Department of Neurology Stavanger University Hospital Stavanger Norway

7. Clinic of Radiology and Nuclear Medicine, University Hospital Basel University of Basel Basel Switzerland

8. Departments of Neuroradiology and Neurology Karolinska University Hospital Stockholm Sweden

9. Department of Neuroradiology, Amsterdam UMC University of Amsterdam Amsterdam The Netherlands

10. Department of Neuroradiology Centre Hospitalier Universitaire de Nantes Nantes France

11. Department of Neuroradiology Monash University Victoria Australia

12. Department of Neurosurgery Hyogo College of Medicine Nishinomiya Hyogo Japan

13. Department of Neurology University of Miami Health System Miami FL

14. Department of Diagnostic and Interventional Neuroradiology University Hospital of Nancy Nancy France

15. Department of Neuroradiology University Hospital Freiburg Freiburg Germany

16. Department of Neuroradiology University of Alberta Edmonton Canada

17. Department of Neurology University of Pittsburgh Medical Center Pittsburgh PA

Abstract

The benefit of acute ischemic stroke (AIS) treatment is highly time dependent. Although studies on workflow improvement in AIS are increasingly gaining attention, there is a lack of consensus and consistency regarding the definition, measurement, and reporting of AIS workflow times. We discuss the challenges related to defining and measuring workflow times in AIS and propose a basic set of time intervals that should be reported in AIS workflow studies. We particularly focus on patients undergoing mechanical thrombectomy. Importantly, endovascular treatment workflow times should always be reported in conjunction with reperfusion quality because one is not informative without the other. We further suggest standardized reporting of workflow times that includes the 90th percentile in addition to medians and interquartile ranges, means, and SDs. The proposed methodology serves as a framework for AIS studies and aids further discussion on workflow‐related AIS research.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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