医学
系统回顾
心理干预
德尔菲法
冲程(发动机)
医疗急救
急诊科
紧急医疗服务
梅德林
急诊医学
护理部
人工智能
计算机科学
机械工程
工程类
政治学
法学
作者
Sushanth Aroor,Cynthia Zevallos,Kaiz Asif,Nishita Singh,Jennifer Potter‐Vig,Aarón Rodríguez-Calienes,Bijoy K. Menon,Aravind Ganesh,Jeffrey L. Saver,Hooman Kamel,Anne W. Alexandrov,Edward C. Jauch,Zhongrong Miao,Xiaochuan Huo,Pankajavalli Ramakrishnan,Shashvat M. Desai,Kaustubh Limaye,Mohammad El‐Ghanem,Gábor Tóth,Chethan Venkatasubba Rao
出处
期刊:Stroke
[Lippincott Williams & Wilkins]
日期:2024-10-25
被引量:2
标识
DOI:10.1161/strokeaha.124.047805
摘要
BACKGROUND: The availability of mechanical thrombectomy (MT) for acute ischemic stroke is limited, and vast disparities exist between countries. We aim to create a MT access score to measure the drivers of access to help quantify and accelerate treatment worldwide. METHODS: We used a systematic review complemented by a modified Delphi method. In the first of 3 rounds, 4 independent investigators performed a systematic literature review using key search terms that drive MT access, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In the second round, a panel of 6 anonymous international experts selected key attributes needed for scoring. In the final round, a total of 12 attributes were selected on consensus, each given a score on a 0 to 3 scale. An ultimate MT access score (range, 0–36) was proposed as a new tool to use in identifying barriers to MT access and assist in providing an initial framework for public health interventions. RESULTS: Of 2864 abstracts screened, 121 studies were included in the final systematic review. A total of 34 attributes that potentially drive MT access were initially identified. In the final round, 12 attributes were selected by the expert panel: public awareness, emergency medical services transportation, prehospital large vessel occlusion screening, interhospital transfer policy, emergency department protocols, stroke imaging protocols, emergency department stroke expertise or telestroke availability, interventionalists, MT-capable centers, device availability, and insurance coverage. These attributes were weighted as part of the final score of 0 to 36. CONCLUSIONS: The MT access score represents the first tool to quantify barriers to global MT access. Its implementation stands not just as an academic achievement but as a beacon of hope for improving stroke care and outcomes worldwide, bringing us a step closer to bridging the gap in stroke treatment disparities.
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