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Stroke: Effect of Implementing an Evaluation and Treatment Protocol Compliant with NINDS Recommendations by James E. Stahl; Karen L. Furie; Suzanne Gleason; G. Scott Gazelle is a Medicine article available to read on EtoBox.

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## PURPOSE: To evaluate-relative to routine clinical practice-the potential costeffectiveness of implementing a strategy compliant with National Institute of Neurological Disorders and Stroke (NINDS) recommendations for care of patients presenting with signs and symptoms of acute ischemic stroke. ## MATERIALS AND METHODS: A discrete-event simulation model of the process of stroke care from symptom onset through administration of tissue plasminogen activator (tPA) was constructed. A literature review was performed to determine process times, performance of computed tomography (CT), health outcomes, and cost estimates. The following were compared: (a) a "base-case" strategy determined on the basis of findings in the literature and (b) a NINDS-compliant strategy (ie, evaluation by emergency physician in less than 10 minutes, interpretation of CT scans within 45 minutes, and administration of tPA within 1 hour after presentation). Strategies were compared with regard to cost and effectiveness. Sensitivity analyses were performed for all relevant cost, timing, and resource parameters. Outcomes of concern were quality-adjusted life years and number of patients treated within a 3-hour the

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Author

James E. Stahl; Karen L. Furie; Suzanne Gleason; G. Scott Gazelle

Publisher

Radiological Society of North America (RSNA)

Published

2003

Language

EN

Field

Medicine (Health Sciences)