Original ArticleAssessment of Long-Term Outcomes for the STRokE DOC Telemedicine Trial
Section snippets
Materials and Methods
The original STRokE DOC trial design has been published.18 STRokE DOC was an National Institutes of Health (NIH)-funded prospective, multisite, randomized trial comparing the decision making efficacy of two consultation techniques. Patients underwent either a telemedicine or telephone-only consultation, with cases reviewed at 3 levels of data availability. Primary outcomes showed correct 98% decision making efficacy for telemedicine, compared with 82% for telephone. Mortality at 90 days did not
Results
Table 1 presents baseline characteristics of our sample. Of the original 222 participants, 35 died within the specified trial period. Of the remaining 187, 75 participants (or surrogates) could be contacted (38 by telephone, 37 by telemedicine). The mean time from original enrollment to contact for STRokE DOC-LTO was 3.96 years (range, 2.33-5.45 years). The mean age of the participants was 67 ± 13 years. The sample was 55% male (P = .65), 93% white (P = .49), and 33% reported being Hispanic (P
Discussion
Recent database information supports the safety and feasibility of “drip and ship” rt-PA models by demonstrating similar discharge status whether treated at outside spoke hospitals and then transferred or treated at hub centers directly.26 Other investigators have reported good outcomes when combining stroke wards, education initiatives, and telemedicine.27 Data also show good long-term outcomes at 6 months.21 Those previous nonrandomized reports are integral to the understanding of
Acknowledgment
We acknowledge the assistance of the California Institute of Telecommunications Technology and BF Technologies for their work in the original STRokE DOC trial, as well as our collaborating hospital sites/participating spoke facilities (Pioneers Memorial Hospital, El Centro Regional Medical Center, Palomar Medical Center, and Twin Cities Memorial Hospital).
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Health technology assessment of telemedicine applications in Northern borders of India
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Pooled assessment of computed tomography interpretation by vascular neurologists in the STRokE DOC telestroke network
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Supported in part by the National Institute of Neurological Disorders and Stroke (Grant P50NS044148).