Findings support concept of telestroke services for decision to administer intravenous thrombolysis
FRIDAY, Feb. 21, 2020 (HealthDay News) — Mobile devices may be reliable and accurate for interpreting images needed in making the clinical decision to administer intravenous (IV) thrombolysis in patients with acute stroke, according to a study published online Feb. 12 in the American Journal of Roentgenology.
Antonio J. Salazar, Ph.D., from University of Los Andes in Bogota, Colombia, and colleagues retrospectively assessed the accuracy and reliability of IV thrombolysis recommendations made with interpretation of head computed tomography images of patients with symptoms of acute stroke via displays on smartphone or laptop reading systems versus interpretation of images displayed on a medical workstation monitor. The analysis included data from 188 patients and four neuroradiologists using the three reading systems for interpretation of five variables: hemorrhagic lesions, intraaxial neoplasm, stroke dating (acute, subacute, chronic), hyperdense arteries, and infarct size assessment.
The researchers found good or very good interobserver and intraobserver agreement for interpretation of each variable. Recommendation for IV thrombolysis showed very good interobserver agreements (intraclass correlation coefficient [ICC], ≥0.85) and very good intraobserver agreements (ICC, ≥0.81). Additionally, for IV thrombolysis recommendation, the area under the curve values (0.83 to 0.84) and sensitivities (0.94 to 0.95) were similar among all the reading systems at a 5 percent equivalent threshold.
“These results constitute a strong foundation for the development of mobile-based telestroke services because they increase neuroradiologist availability and the possibility of using reperfusion therapies in resource-limited countries,” Salazar said in a statement.
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