Abstract
AbstractBackgroundThe 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 used almost solely by trained neurologists in the emergency departments (ED) setting. CVA-Flow (CVAid medical Ltd., Tel-Aviv, Israel) is a smartphone-based Telestroke system that captures the full NIHSS by video and enables a distant stroke physician to assess the patient’s neurological status, bringing forward the NIHSS to the pre-hospital setting.ObjectiveWe aimed to compare the reliability of an NIHSS score determined by a neurologist from afar, using the CVA-Flow platform, with a standard NIHSS assessment performed in the ED).MethodsIn this multi-center prospective trial, Patients admitted to the ED in Rambam hospital in Haifa, Israel, and Vall d’Hebron hospital (VdH) in Barcelona, Spain, had a neurological exam based on the NIHSS while being recorded by the system. A neurologist blinded to the results rated the NIHSS according to the videos offline.ResultsA total of 95 patients with a suspected stroke were included. Overall ICC 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 collected by the CVA-Flow platform, installed on a standard smartphone, is a reliable measurement as compared with bedside evaluation.
Publisher
Cold Spring Harbor Laboratory