ReviewFrontiers in neurology2026
Telestroke systems and thrombolysis decisions: diagnostic uncertainty, treatment thresholds, and stroke mimics.
Review in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Telestroke expands access to specialist stroke care and is associated with increased use of intravenous thrombolysis (IVT). Whether this reflects improved access alone or also changes how clinicians act under diagnostic uncertainty remains unclear. Purpose: To review evidence on telestroke-associated thrombolysis, stroke mimics, and decision-making, and to examine the hypothesis that telestroke may influence the practical threshold for IVT. Methods: We conducted a narrative review of studies addressing telestroke implementation, IVT utilization, stroke mimic frequency and safety, remote neurological assessment, and decision-related features of telestroke care. Evidence was synthesized around three proposed domains: risk asymmetry, information constraints and diagnostic friction, and distributed responsibility with workflow pressure. Results: Telestroke is consistently associated with greater thrombolysis utilization, while stroke mimics remain common among both evaluated and treated patients. Serious hemorrhagic complications after thrombolysis of stroke mimics are uncommon. However, existing studies are predominantly observational and do not directly measure clinicians' diagnostic confidence or treatment thresholds. Higher IVT rates and mimic treatment may therefore reflect improved specialist access, faster workflows, case mix, or other system-level factors rather than a lower threshold for treatment. Conclusion: Current evidence does not demonstrate that telestroke lowers the thrombolysis threshold. Instead, a treatment-threshold shift should be regarded as a testable hypothesis. Future studies should directly measure diagnostic confidence, estimated stroke probability, competing diagnoses, and treatment decisions to determine how telestroke influences clinical decision-making under uncertainty.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.