Evidence map›Paper›PMID 27398382›Full record

ArticleCMAJ open

Predictors of diagnostic neuroimaging delays among adults presenting with symptoms suggestive of acute stroke in Ontario: a prospective cohort study.

Kirsteen R Burton, Moira K Kapral, Shudong Li, Jiming Fang, Alan R Moody, Murray Krahn, Andreas Laupacis

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Kirsteen R BurtonInstitute of Health Policy, Management and Evaluation (Burton, Kapral, Krahn, Laupacis), University of Toronto; Departments of Medical Imaging (Burton, Moody) and Medicine (Kapral, Krahn, Laupacis), University of Toronto; Institute for Clinical Evaluative Sciences (Kapral, Li, Fang); Institute of Medical Sciences (Moody), University of Toronto; Toronto Health Economics and Technology Assessment Collaborative (Krahn), University of Toronto; Li Ka Shing Knowledge Institute (Laupacis), St. Michael's Hospital, Toronto, Ont.
Moira K KapralInstitute of Health Policy, Management and Evaluation (Burton, Kapral, Krahn, Laupacis), University of Toronto; Departments of Medical Imaging (Burton, Moody) and Medicine (Kapral, Krahn, Laupacis), University of Toronto; Institute for Clinical Evaluative Sciences (Kapral, Li, Fang); Institute of Medical Sciences (Moody), University of Toronto; Toronto Health Economics and Technology Assessment Collaborative (Krahn), University of Toronto; Li Ka Shing Knowledge Institute (Laupacis), St. Michael's Hospital, Toronto, Ont.
Shudong LiInstitute of Health Policy, Management and Evaluation (Burton, Kapral, Krahn, Laupacis), University of Toronto; Departments of Medical Imaging (Burton, Moody) and Medicine (Kapral, Krahn, Laupacis), University of Toronto; Institute for Clinical Evaluative Sciences (Kapral, Li, Fang); Institute of Medical Sciences (Moody), University of Toronto; Toronto Health Economics and Technology Assessment Collaborative (Krahn), University of Toronto; Li Ka Shing Knowledge Institute (Laupacis), St. Michael's Hospital, Toronto, Ont.
Jiming FangInstitute of Health Policy, Management and Evaluation (Burton, Kapral, Krahn, Laupacis), University of Toronto; Departments of Medical Imaging (Burton, Moody) and Medicine (Kapral, Krahn, Laupacis), University of Toronto; Institute for Clinical Evaluative Sciences (Kapral, Li, Fang); Institute of Medical Sciences (Moody), University of Toronto; Toronto Health Economics and Technology Assessment Collaborative (Krahn), University of Toronto; Li Ka Shing Knowledge Institute (Laupacis), St. Michael's Hospital, Toronto, Ont.
Alan R MoodyInstitute of Health Policy, Management and Evaluation (Burton, Kapral, Krahn, Laupacis), University of Toronto; Departments of Medical Imaging (Burton, Moody) and Medicine (Kapral, Krahn, Laupacis), University of Toronto; Institute for Clinical Evaluative Sciences (Kapral, Li, Fang); Institute of Medical Sciences (Moody), University of Toronto; Toronto Health Economics and Technology Assessment Collaborative (Krahn), University of Toronto; Li Ka Shing Knowledge Institute (Laupacis), St. Michael's Hospital, Toronto, Ont.
Murray KrahnInstitute of Health Policy, Management and Evaluation (Burton, Kapral, Krahn, Laupacis), University of Toronto; Departments of Medical Imaging (Burton, Moody) and Medicine (Kapral, Krahn, Laupacis), University of Toronto; Institute for Clinical Evaluative Sciences (Kapral, Li, Fang); Institute of Medical Sciences (Moody), University of Toronto; Toronto Health Economics and Technology Assessment Collaborative (Krahn), University of Toronto; Li Ka Shing Knowledge Institute (Laupacis), St. Michael's Hospital, Toronto, Ont.
Andreas LaupacisInstitute of Health Policy, Management and Evaluation (Burton, Kapral, Krahn, Laupacis), University of Toronto; Departments of Medical Imaging (Burton, Moody) and Medicine (Kapral, Krahn, Laupacis), University of Toronto; Institute for Clinical Evaluative Sciences (Kapral, Li, Fang); Institute of Medical Sciences (Moody), University of Toronto; Toronto Health Economics and Technology Assessment Collaborative (Krahn), University of Toronto; Li Ka Shing Knowledge Institute (Laupacis), St. Michael's Hospital, Toronto, Ont.
Institute for Clinical Evaluative Sciences · CAUniversity of Toronto · CAInstitute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany studies have examined the timeliness of thrombolysis for acute ischemic stroke, but less is known about door-to-imaging time. We conducted a prospective cohort study to assess the timing of neuroimaging among patients with suspected acute stroke in the province of Ontario, Canada, and to examine factors associated with delays in neuroimaging.

methodsWe included all patients 18 years and older with suspected acute stroke seen at hospitals with neuroimaging capacity within the Ontario Stroke Registry between Apr. 1, 2010, and Mar. 31, 2011. We used a hierarchical, multivariable Cox proportional hazards model to evaluate the association between patient and hospital factors and the likelihood of receiving timely neuroimaging (≤ 25 min) after arrival in the emergency department.

resultsA total of 13 250 patients presented to an emergency department with stroke-like symptoms during the study period. Of the 3984 who arrived within 4 hours after symptom onset, 1087 (27.3%) had timely neuroimaging. The factors independently associated with an increased likelihood of timely neuroimaging were less time from symptom onset to presentation, more severe stroke, male sex, no history of stroke or transient ischemic attack, arrival to hospital from a setting other than home and presentation to a designated stroke centre or an urban hospital.

interpretationA minority of patients with stroke-like symptoms who presented within the 4-hour thrombolytic treatment window received timely neuroimaging. Neuroimaging delays were influenced by various patient and hospital factors, some of which are modifiable.

Identifiers

PMID27398382
PMCPMC4933639
OpenAlexW2460920515

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.