Quantifying Improved Outcomes, Cost Savings, and Hospital Volume Changes From Optimized Emergency Stroke Transport
Daniel A. Paydarfar*, Jessalyn K. Holodinsky, Huda Abbas, Thalia S. Field, Lily W. Zhou, and Noreen Kamal. "Quantifying improved outcomes, cost savings, and hospital volume changes from optimized emergency stroke transport." Stroke. 2022; 53(12), 3644-3651. https://doi.org/10.1161/STROKEAHA.122.039172
Background: A previously published conditional probability model optimizes prehospital emergency transport protocols for patients with suspected large-vessel occlusion by recommending the transport strategy, drip-and-ship or mothership, that results in a higher probability of an excellent outcome.
Improving Access and Efficiency of Ischemic Stroke Treatment Across Four Canadian Provinces Using a Stepped Wedge Trial: Methodology
Kamal N., Aljendi S., Cora E.A, Chandler T., Clift F., Fok P.T., Goldstein J., Gubitz G., Hill M.D., Menon B.K., Metcalfe B., Mrklas K.J., Phillips S., Theriault S., Van Der Linde E., Volders D., Williams H., ACTEAST Collaborators. (2022). Improving Access and Efficiency of Ischemic Stroke Treatment Across Four Canadian Provinces Using a Stepped Wedge Trial: Methodology. Frontiers in Stroke. 1, 1-12.
Introduction: Ischemic stroke is treatable with thrombolysis and/or endovascular treatment. Both treatments are highly time dependent, as faster treatment results in better outcomes. Utilization of both of these treatments is less than optimal, and treatment times continue to exceed the recommended benchmarks.
Kamal, N., Yu, A.Y.Z. (2023). Addressing Access to Stroke Treatment for Patients with Pre-Existing Disabilities. Canadian Journal of Neurological Sciences. https://doi.org/10.1017/cjn.2023.5
Paydarfar, D.A., Holodinsky, J.K., Abbas, H., Field, T.S., Zhou, L.W., Kamal, N. (2022). Quantifying Improved Outcomes, Cost Saving, and Hospital Volume Changes From Optimized Emergency Stroke Transport. Stroke. 53(12). 3644-3651. https://doi.org/10.1161/STROKEAHA.122.039172
Kamal N., Aljendi S., Cora E.A, Chandler T., Clift F., Fok P.T., Goldstein J., Gubitz G., Hill M.D., Menon B.K., Metcalfe B., Mrklas K.J., Phillips S., Theriault S., Van Der Linde E., Volders D., Williams H., ACTEAST Collaborators. (2022). Improving Access and Efficiency of Ischemic Stroke Treatment Across Four Canadian Provinces Using a Stepped Wedge Trial: Methodology. Frontiers in Stroke. 1, 1-12. https://doi.org/10.3389/fstro.2022.1014480
Kamal, N. Lakshminarayan, K. (2022). Simulation and Machine Learning Provide New Approaches to Examine Quality of Acute Stroke Management. Stroke. 53(9), 2768-2769. https://doi.org/10.1161/STROKEAHA.122.039954
Wheaton, A., For, P.T., Holodinsky, J.K., Vanberkel, P., Volders, D., Kamal, N. (2021). Optimal Transport Scenario with Rotary Air Transport for Access to Endovascular Therapy Considering Patient Outcomes and Cost: A Modelling Study. Frontiers in Neurology. 2021; 17:article769381. https://doi.org/10.3389/fneur.2021.768381
Bulmer, T., Volders, D., Blake, J., Kamal, N. (2021). Discrete-event simulation to model the thrombolysis process for acute ischemic stroke patients at urban and rural hospitals. Frontiers in Neurology. 2021;12:article746404. https://doi.org/10.3389/fneur.2021.746404
Gillis, M., Saif, A., Murphy, M., Kamal, N. (2021). Effects of Various Policy Options on Covid-19 Cases in Nova Scotia Including Vaccination Rollout Schedule: A Modelling Study, MedRxIV, July. https://doi.org/10.1101/2021.07.28.21261219
Bulmer, T., Volders, D., & Kamal, N. (2021). Analysis of thrombolysis process for acute ischemic stroke in urban and rural hospitals in Nova Scotia Canada. Frontiers in Neurology, 12. doi:https://doi.org/10.3389/fneur.2021.645228
Kamal, N., Jeerakathil, T., Stang, J., Liu, M., Rogers, E., Smith, E. E., ... & Hill, M. D. (2020). Provincial Door-to-Needle Improvement Initiative Results in Improved Patient Outcomes Across an Entire Population. Stroke, 51(8), 2339-2346. doi:https://doi.org/10.1161/STROKEAHA.120.029734
Holodinsky JK, Kamal N, Zerna C, Ospel JM, Zhu L, Wilson LT, Hill MD, and Goyal M. (2020). In what scenarios does a mobile stroke unit predict better patient outcomes? A modelling study. Stroke, 51(6), 1805-1812. doi:https://doi.org/10.1161/STROKEAHA.119.028474
Kamal N, Rogers E, Stang J, Mann B, Butcher KS, Rempel J, Jeerakathil T, Shuaib A, Goyal M, Menon BK, Demchuk AM, Hill MD. (2019). 1-Year Healthcare Utilization for Patients that Received Endovascular Treatment Compared to Control. Stroke, 50, 1883-1886. doi:https://doi.org/10.1161/STROKEAHA.119.024870
Kamal N, Shand E, Swanson R, Hill MD, Jeerakthil T, Imoukhuede O, Heinrichs I, Bakker J, Stoyberg C, Fowler L, Duckett S, Holsworth S, Mann B, Valaire S, Bestard J. (2019). Reducing door-to-needle times for acute ischemic stroke to a median of 30 minutes at a community hospital: a cohort study. Canadian Journal of Neurosciences, 46(1), 51-56. doi:https://doi.org/10.1017/cjn.2018.368
Holodinsky JK, Williamson TS, Demchuk AM, Zhao H, Zhu L, Francis MJ, Goyal M, Hill MD, Kamal N. (2018). Drip ‘n ship vs. mothership: modelling stroke patient transport for all suspected large vessel occlusion patients. JAMA Neurology, 75(12), 1477-1486. doi:https://doi.org/10.1001/jamaneurol.2018.2424
Kamal N, Wiggam MI, Holodinsky JK, Francis MJ*, Hopkins E, Frei D, Baxter B, Williams M, Nygren A, Goyal M, Hill MD, Jayaraman M. (2018). Geographic Modeling of Best Transport Options for Treatment of Acute Ischemic Stroke Patients: Applied to Influencing Health Policy in the USA and Northern Ireland. IISE Transactions on Healthcare Systems Engineering, 8(3), 220-226. doi:https://doi.org/10.1080/24725579.2018.1501623
Kamal N, Sheng S, Xian Y, Matsoualka R, Hill MD, Bhatt D, Saver J, Reeves M, Fonarow GC, Schwamm LH, and Smith EE. (2017). Delays in door-to-needle times and their impacton treatment time and outcomes in Get With the Guidelines Stroke. Stroke, 48, 946-954. doi:https://doi.org/10.1161/STROKEAHA.116.015712
Kamal N, Smith EE, Jeerakathil T, Hill MD. (2017). Thrombolysis: Improving door-to-needle times for ischemic stroke treatment, a narrative review. International Journal of Stroke, 13(3), 268–276. doi:https://doi.org/10.1177/1747493017743060