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Original research
The VITAL study and overall pooled analysis with the VIPS non-invasive stroke detection device
  1. Christopher P Kellner1,
  2. Eric Sauvageau2,
  3. Kenneth V Snyder3,
  4. Kyle M Fargen4,
  5. Adam S Arthur5,
  6. Raymond D Turner6,
  7. Andrei V Alexandrov7
  1. 1 Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
  2. 2 Department of Neurosurgery, Lyerly Neurosurgery, Jacksonville, Florida, USA
  3. 3 University at Buffalo, Department of Neurosurgery, Buffalo, New York, USA
  4. 4 Department of Neurosurgery, Wake Forest University, Winston-Salem, North Carolina, USA
  5. 5 Department of Neurosurgery, University of Tennessee Health Sciences Center and Semmes-Murphey Clinic, Memphis, TN, USA
  6. 6 Department of Neurosciences, Medical University of South Carolina, Mount Pleasant, South Carolina, USA
  7. 7 Department of Neurology, University of Tennessee Health Sciences Center and Semmes-Murphey Clinic, Memphis, TN, USA
  1. Correspondence to Dr Christopher P Kellner, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; christopher.kellner{at}mountsinai.org

Abstract

Introduction Effective triage of patients with emergent large vessel occlusion (ELVO) to endovascular therapy capable centers may decrease time to treatment and improve outcome for these patients. Here we performed a derivation study to evaluate the accuracy of a portable, non-invasive, and easy to use severe stroke detector.

Methods The volumetric impedance phase shift spectroscopy (VIPS) device was used to assign a bioimpedance asymmetry score to 248 subjects across three cohorts, including 41 subjects presenting as acute stroke codes at a major comprehensive stroke center (CSC), 79 healthy volunteers, and 128 patients presenting to CSCs with a wide variety of brain pathology including additional stroke codes. Diagnostic parameters were calculated for the ability of the device to discern (1) severe stroke from minor stroke and (2) severe stroke from all other subjects. Patients with intracranial hardware were excluded from the analysis.

Results The VIPS device was able to differentiate severe stroke from minor strokes with a sensitivity of 93% (95% CI 83 to 98), specificity of 92% (95% CI 75 to 99), and an area under the curve (AUC) of 0.93 (95% CI 0.85 to 0.97). The device was able to differentiate severe stroke from all other subjects with a sensitivity of 93% (95% CI 83 to 98), specificity of 87% (95% CI 81 to 92), and an AUC of 0.95 (95% CI 0.89 to 0.96).

Conclusion The VIPS device is a portable, non-invasive, and easy to use tool that may aid in the detection of severe stroke, including ELVO, with a sensitivity of 93% and specificity of 92% in this derivation study. This device has the potential to improve the triage of patients suffering severe stroke.

  • device
  • intervention
  • stroke
  • thrombectomy

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors CPK, ASA, RDT, and AA participated in the study concept and design. CPK, ES, KS, and RDT participated in data collection. CPK, ASA, and AA contributed to data analysis and interpretation. CPK drafted the manuscript. KMF, ASA, and AA performed the critical revisions, and all authors provided final approval of the submitted manuscript and revisions.

  • Funding This study was funded by Cerebrotech Medical Systems.

  • Competing interests Adam Arthur has financial interest in Cerebrotech Medical Systems.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval The study was approved by the institutional review board at each medical center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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