Establishment of an internationally agreed minimum data set for acute telestroke

Author:

Cadilhac Dominique A12ORCID,Bagot Kathleen L12ORCID,Demaerschalk Bart M3,Hubert Gordian4,Schwamm Lee5,Watkins Caroline L6,Lightbody Catherine Elizabeth6,Kim Joosup12,Vu Michelle7,Pompeani Nancy1ORCID,Switzer Jeffrey8,Caudill Juanita8,Estrada Juan5,Viswanathan Anand5,Hubert Nikolai4,Ohannessian Robin910ORCID,Hargroves David11,Roberts Nicholas12,Ingall Timothy13,Hess David C8,Ranta Annemarei14ORCID,Padma Vasantha15,Bladin Christopher F11617

Affiliation:

1. Public Health Group, Stroke Division, Florey Institute of Neuroscience and Mental Health, the University of Melbourne, Australia

2. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia

3. Department of Neurology and Center for Connected Care, Mayo Clinic College of Medicine and Science, USA

4. TEMPiS Telemedical Stroke Center, Department of Neurology, München Klinik Harlaching, Germany

5. Partners Telestroke Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, USA.

6. Faculty of Health and Wellbeing, University of Central Lancashire, UK

7. Clinical Services, Epworth HealthCare, Richmond, Australia

8. Department of Neurology, Medical College of Georgia at Augusta University, USA

9. Laboratoire de Neurosciences Intégratives et Cliniques, Université de Franche-Comté, France

10. Télémédecine 360, TLM360, Paris, France

11. East Kent Hospital University NHS Foundation Trust, UK

12. Department of Medicine for Older People, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, UK

13. Department of Neurology, Mayo Clinic College of Medicine and Science, USA

14. Department of Medicine, University of Otago Wellington, New Zealand

15. Department of Neurology, AIIMS, India

16. Ambulance Victoria, Melbourne, Australia

17. Eastern Health Clinical School, Melbourne, Australia

Abstract

Introduction Globally, the use of telestroke programmes for acute care is expanding. Currently, a standardised set of variables for enabling reliable international comparisons of telestroke programmes does not exist. The aim of the study was to establish a consensus-based, minimum dataset for acute telestroke to enable the reliable comparison of programmes, clinical management and patient outcomes. Methods An initial scoping review of variables was conducted, supplemented by reaching out to colleagues leading some of these programmes in different countries. An international expert panel of clinicians, researchers and managers ( n = 20) from the Australasia Pacific region, USA, UK and Europe was convened. A modified-Delphi technique was used to achieve consensus via online questionnaires, teleconferences and email. Results Overall, 533 variables were initially identified and harmonised into 159 variables for the expert panel to review. The final dataset included 110 variables covering three themes (service configuration, consultations, patient information) and 12 categories: (1) details about telestroke network/programme ( n = 12), (2) details about initiating hospital ( n = 10), (3) telestroke consultation ( n = 17), (4) patient characteristics ( n = 7), (5) presentation to hospital ( n = 5), (6) general clinical care within first 24 hours ( n = 10), (7) thrombolysis treatment ( n = 10), (8) endovascular treatment ( n = 13), (9) neurosurgery treatment ( n = 8), (10) processes of care beyond 24 hours ( n = 7), (11) discharge information ( n = 5), (12) post-discharge and follow-up data ( n = 6). Discussion The acute telestroke minimum dataset provides a recommended set of variables to systematically evaluate acute telestroke programmes in different countries. Adoption is recommended for new and existing services.

Funder

National Health and Medical Research Council Research Fellowship

Publisher

SAGE Publications

Subject

Health Informatics

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