TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention' in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 34% 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
3 citing papers in PubMed, 4 citations in OpenAlex.
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
32 authors at 14 institutions in 1 country.
Annika RyanSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0002-0487-7403
Christine L PaulSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0002-0504-5246
Martine CoxSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0001-7210-2629
Olivia WhalenSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0001-8927-6959
Andrew BivardDepartment of Medicine and Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.ORCID 0000-0001-7762-5832
John AttiaSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0001-9800-1308
Christopher BladinEastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.
Stephen M DavisDepartment of Medicine and Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.ORCID 0000-0003-0962-2300
Bruce C V CampbellDepartment of Medicine and Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.ORCID 0000-0003-3632-9433
Mark ParsonsSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0001-8874-2487
Rohan S GrimleyQueensland State-wide Stroke Clinical Network, Healthcare Improvement Unit, Queensland Health, Herston, Queensland, Australia.ORCID 0000-0002-7006-6908
Craig AndersonThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-7248-4863
Geoffrey A DonnanDepartment of Medicine and Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.ORCID 0000-0001-6324-3403
Christopher OldmeadowData Sciences, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.ORCID 0000-0001-6104-1322
Sarah KuhleQueensland State-wide Stroke Clinical Network, Healthcare Improvement Unit, Queensland Health, Herston, Queensland, Australia.ORCID 0000-0002-7623-4327
Frederick R WalkerCentre for Advanced Training Systems, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0002-9068-0761
Rebecca J HoodHunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.ORCID 0000-0001-7485-4883
Steven MaltbyCentre for Advanced Training Systems, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0003-1240-5964
Angela KeynesCentre for Advanced Training Systems, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.
Candice DelcourtThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0003-2257-4286
Luke HatchwellThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0001-5952-8254
Alejandra MalaveraThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-6084-4315
Arman SabetSchool of Medicine, Griffith University, Southport, Queensland, Australia.ORCID 0000-0002-3469-6638
Carlos Garcia-EsperonHunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.ORCID 0000-0001-8843-5890
Helen BrownPrincess Alexandra Hospital, Woolloongabba, Queensland, Australia.ORCID 0000-0001-9142-2708
Neil SprattDivision of Medicine, Department of Neurology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.ORCID 0000-0002-9023-6177
Timothy KleinigDepartment of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.ORCID 0000-0003-4430-3276
Ken ButcherDepartment of Neurology, Liverpool Hospital, Ingham Institute for Applied Medical Research, University of New South Wales South Western Sydney Clinical School, Liverpool, New South Wales, Australia.ORCID 0000-0002-0590-7918
Christopher R LeviSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia christopher.levi@health.nsw.gov.au.ORCID 0000-0002-9474-796X
Hunter Medical Research Institute · AUThe Royal Melbourne Hospital · AUUNSW Sydney · AUUniversity of Newcastle Australia · AUGriffith University · AULiverpool Hospital · AUQueensland Health · AUApollo Medical Imaging Technology (Australia) · AUEastern Health · AUHunter New England Local Health District · AUJohn Hunter Hospital · AUPrincess Alexandra Hospital · AURoyal Adelaide Hospital · AUThe University of Queensland · AU
Funding
No grant is acknowledged in the PubMed record.
6 · The paper itself
Abstract
introductionStroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia's rural and remote populations in accessing EVT, but improved access can be facilitated by a 'drip and ship' approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aims to test whether a multicomponent, multidisciplinary implementation intervention can increase the proportion of stroke patients receiving EVT. METHODS AND ANALYSIS: This is a non-randomised controlled, stepped wedge trial involving six clusters across three Australian states. Each cluster comprises one CSC hub and a minimum of three primary stroke centre (PSC) spokes. Hospitals will work in a hub and spoke model of care with access to a multislice CT scanner and CT perfusion image processing software (MIStar, Apollo Medical Imaging). The intervention, underpinned by behavioural theory and technical assistance, will be allocated sequentially, and clusters will move from the preintervention (control) period to the postintervention period. PRIMARY OUTCOME: Proportion of all stroke patients receiving EVT, accounting for clustering. SECONDARY OUTCOMES: Proportion of patients receiving IVT at PSCs, proportion of treated patients (IVT and/or EVT) with good (modified Rankin Scale (mRS) score 0-2) or poor (mRS score 5-6) functional outcomes and European Quality of Life Scale scores 3 months postintervention, proportion of EVT-treated patients with symptomatic haemorrhage, and proportion of reperfusion therapy-treated patients with good versus poor outcome who presented with large vessel occlusion at spokes. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Hunter New England Human Research Ethics Committee (18/09/19/4.13, HREC/18/HNE/241, 2019/ETH01238). Trial results will be disseminated widely through published manuscripts, conference presentations and at national and international platforms regardless of whether the trial was positive or neutral. TRIAL REGISTRATION NUMBER: ACTRN12619000750189; UTNU1111-1230-4161.
Indexed as
Brain IschemiaEndovascular ProceduresIschemic StrokeStrokeAustraliaHumansNon-Randomized Controlled Trials as TopicQuality of LifeReperfusionThrombectomyThrombolytic TherapyTomography, X-Ray ComputedTreatment Outcomechange managementeducation & training (see medical education & training)interventional radiologyquality in health carestroke medicine
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.
TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention' in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke. · full record | OpenQuestion