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Updated: Jul 2, 2026
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
The STRokE DOC trial technique: 'video clip, drip, and/or ship'
1Department of Neurosciences, UCSD School of Medicine, San Diego, CA 92103-8466, USA. bcmeyer@ucsd.edu
Summary
This study explored a site-independent telemedicine system for acute stroke care, showing it is feasible for remote consultations and treatment decisions. Further research is needed to confirm its effectiveness in increasing rt-PA administration.
Area of Science:
- Neurology
- Telemedicine
- Clinical Trials
Background:
- Limited access to stroke expertise in rural areas contributes to low rates of timely treatment with rt-PA.
- Existing telemedicine systems often require fixed base stations, potentially causing delays in acute stroke care.
- Site-independent telemedicine systems offer a potential solution to minimize delays and improve access to stroke expertise.
Purpose of the Study:
- To evaluate the effectiveness and efficiency of a site-independent telemedicine system (STRokE DOC) for delivering rt-PA to remote populations.
- To assess the feasibility of conducting site-independent stroke consultations and case adjudication using telemedicine technology.
Main Methods:
- The STRokE DOC trial is a 5-year, 400-participant, noninvasive study comparing telemedicine consultations with standard telephone consultations at four remote sites.
- Participants are randomized to either the STRokE DOC telemedicine or telephone consultation group.
- Treatment decision accuracy is adjudicated at two time points using three data availability levels and an independent auditor.
Main Results:
- The study demonstrated the feasibility of performing site-independent stroke consultations and adjudicating cases using the STRokE DOC system.
- Initial 'run-in' data from 11 patients showed successful wireless and wired evaluations, with 27% receiving rt-PA.
- The adjudication methodology proved capable of identifying both agreement and disagreement in treatment decisions.
Conclusions:
- Site-independent telemedicine consultations for acute stroke are feasible and can be adjudicated effectively.
- The STRokE DOC trial design is suitable for evaluating telemedicine efficacy in remote stroke care.
- Further evidence is required to establish the definitive efficacy of telemedicine in improving rt-PA utilization and patient outcomes.
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