Evidence map›Paper›PMID 34515063›Full record

ArticleCerebrovascular diseases (Basel, Switzerland)2022

Community Intent to Activate Emergency Medical Services May Be Associated with Regional tPA Treatment.

Mellanie V Springer, Ran Bi, Lesli E Skolarus, Chun Chieh Lin, James F Burke

Open access · greenAbstract read
In one paragraph

Article in Cerebrovascular diseases (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 85% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Trial
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

5 authors at 1 institution in 1 country.

Mellanie V SpringerStroke Program, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Ran BiUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.
Lesli E SkolarusStroke Program, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Chun Chieh LinUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.
James F BurkeStroke Program, University of Michigan Medical School, Ann Arbor, Michigan, USA.
University of Michigan–Ann Arbor · US

Funding

A Community Based Participatory Trial to Increase Stroke TreatmentU01MD010579 · NIMHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BROWN, DEVIN L · 2016 to 2020
$2.8M
NIMHD NIH HHS U01 MD010579
6 · The paper itself

Abstract

introductionAcute stroke treatments are underutilized in the USA. Enhancing stroke preparedness, the recognition of stroke symptoms, and intent to call emergency medical services (EMS) could reduce delay in hospital arrival thereby increasing eligibility for time-sensitive stroke treatments. Whether higher stroke preparedness is associated with higher tissue plasminogen activator (tPA) treatment rates is however uncertain. We therefore set out to determine the contribution of stroke preparedness to regional variation in tPA treatment.

methodsThe region was defined by hospital service area (HSA). Stroke preparedness was determined by using Behavioral Risk Factor Surveillance System survey questions assessing stroke symptom recognition and intent to call 911 in response to a stroke. We used Medicare data to determine the percentage of tPA-treated hospitalized stroke patients in 2007, 2009, and 2011, adjusting for number of stroke hospitalizations in each HSA (primary outcome). We performed multivariate linear regression to estimate the association of regional stroke preparedness on log-transformed tPA treatment rates controlling for demographic, EMS, and hospital characteristics.

resultsThe adjusted percentage of stroke patients receiving tPA ranged from 1.4% (MIN) to 11.3% (MAX) of stroke/TIA hospitalizations. Across HSAs, a median (IQR) of 86% (81-90%) of responses to a witnessed stroke indicated intent to call 911, and a median (IQR) of 4.4 (4.2-4.6) out of 6 stroke symptoms was recognized. Every 1% increase in an HSA's intent to call 911 was associated with a 0.44% increase in adjusted tPA treatment rate (p = 0.05). Lower accuracy of recognition of stroke symptoms was associated with higher adjusted tPA treatment rates (p = 0.05).

conclusionsThere was little regional variation in intent to call EMS and stroke symptom recognition. Intent to call EMS and stroke symptom recognition are modest contributors to regional variation in tPA treatment.

Indexed as

Emergency Medical ServicesStrokeAgedFibrinolytic AgentsHumansMedicareTissue Plasminogen ActivatorUnited StatesFibrinolytic AgentsTissue Plasminogen ActivatorIschemic strokeStroke preparednessStroke treatmentTissue plasminogen activator

Identifiers

PMID34515063
PMCPMC8898989
OpenAlexW3197842375

What OpenQuestion holds

Textmetadata
LicenceTDM
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.