Enhancing Stroke Prehospital and Emergency Evaluation and Delivery (E-SPEED)

加强中风院前和急诊评估和实施 (E-SPEED)

• 批准号: 10022542
• 负责人: Shyam Prabhakaran
• 金额: $ 38.42万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-03 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10022542
• 关键词: Enhancing; Stroke; Prehospital; Emergency; Evaluation

Nearly 800,000 people in the United States (US) each year are affected by stroke, which remains the leading cause of adult disability and 5th leading cause of death. Despite the proliferation of stroke centers nationwide, access to timely stroke care and evidence-based therapies is still poor with multiple inefficiencies, redundancies, errors, and system-based barriers that lead to care fragmentation. A stroke system of care that integrates and coordinates care between non-stroke center hospitals, primary stroke centers, and comprehensive stroke centers has been recommended since it would reduce stroke-related deaths by 20,000 annually in the US and nearly 400,000 worldwide. This proposal is significant because it addresses two important gaps in knowledge about the acute evaluation and treatment of stroke patients: prehospital screening errors and delays in inter-hospital transfer. The Enhancing Stroke Prehospital and Emergency Evaluation and Delivery (E-SPEED) study will (1) enhance existing LVO screening tools, assess whether machine learning approaches improve LVO prediction, and evaluate the impact of an Enhanced LVO Screening Tool in the prehospital setting; and (2) use learning collaboratives and simulations to design, implement, and pilot test a new inter-hospital stroke transfer protocol. We bring together systems engineers and stroke health service researchers in a novel collaboration that will produce generalizable knowledge that can be widely applied to other urban regions of the country and provide preliminary data and demonstration of novel approaches that could be evaluated in large-scale comparative effectiveness studies across multiple regions.

在美国，每年有近 80 万人受到中风的影响，中风仍然是头号疾病 成人残疾的原因和第五大死亡原因。尽管全国范围内的中风中心不断增加， 及时获得中风护理和循证治疗的机会仍然很差，效率低下， 导致护理分散的冗余、错误和系统障碍。中风护理系统 整合和协调非中风中心医院、初级中风中心和 建议建立综合性中风中心，因为它可以减少 20,000 例中风相关死亡 每年在美国和全世界有近 400,000 人。该提案意义重大，因为它解决了两个问题 关于中风患者的急性评估和治疗的重要知识差距：院前 筛查错误和院间转移延误。加强中风院前和急救 评估和交付 (E-SPEED) 研究将 (1) 增强现有的 LVO 筛查工具，评估是否 机器学习方法改进 LVO 预测，并评估增强型 LVO 的影响 院前环境中的筛查工具； (2) 使用学习协作和模拟来设计、 实施并试点新的院间卒中转移协议。我们汇集了系统工程师 和中风健康服务研究人员开展一项新颖的合作，该合作将产生可推广的知识 可广泛应用于全国其他城市地区，并提供初步数据和示范 可以在多个国家的大规模比较有效性研究中评估的新方法 地区。